Endoscopic Retrograde Cholangiopancreatography (ERCP)

An endoscopic retrograde cholangiopancreatography (ERCP) procedure combines an upper gastrointestinal endoscopy and x-ray examination to diagnose and treat conditions of the bile and pancreatic ducts.

Bile is a digestive fluid produced by the liver and delivered to the upper part of the small intestines called the duodenum through a series of small tubes or ducts. The pancreas also produces digestive fluids which it delivers to the duodenum through the pancreatic duct. The bile duct and the pancreatic duct join together to empty their digestive juices into the duodenum at a structure called the Papilla of Vater.

If your gastroenterologist suspects that these ducts may have become narrowed or blocked, an ERCP may be used to examine and reopen them.

There are several conditions that can cause the bile or pancreatic ducts to become narrowed or blocked. Gallstones, inflammation or infection, scarring and in some cases tumors may partially or fully obstruct the ducts.

The ERCP Procedure

If your gastroenterologist recommends an ERCP, you will be provided with detailed information about the procedure including how to prepare for it.

You will be asked not to eat or drink within 8 hours of the procedure. Ensure that you have given your gastroenterologist a complete list of the medications you are taking as some of them may be stopped prior to your ERCP.

ERCP is performed in a hospital setting. You will be given intravenous sedation during the procedure to help you relax so that you are comfortable. A thin tube called an endoscope is inserted through the mouth and passed down through the esophagus and stomach into the duodenum. Using the endoscope a blunt tube is inserted into the ducts where the bile and pancreatic fluid enter the duodenum. Dye is injected into the ducts allowing the ducts to be seen on an x ray. Any blockages or narrowing can be seen and various techniques can then be used to clear the blockage or widen narrow areas. It is common for cells to be collected from within the ducts and examined in a laboratory for signs of infection or cancer.

After Your ERCP

After the ERCP procedure you will be taken to a recovery room where you can rest until the sedatives wear off. This generally takes about an hour. Your doctor will talk with you before you leave the endoscopy center and nurses will give you complete instructions about returning to normal activity and diet. You should plan to rest when you return home as you will most likely be tired for the remainder of the day.

Side Effects and Risks

The most common side effect of an ERCP is a mild, temporary sore throat. Serious complications as a result of an ERCP are uncommon. Detailed information about the ERCP will be provided and your doctor will discuss the procedure along with the benefits, risks and possible side effects with you to make sure you understand all that is involved.

For more information please visit The American Society for Gastrointestinal Endoscopy.

For more information on the ERCP, please contact us to schedule an appointment.