What is ERCP?

Endoscopic retrograde cholangiopancreatography (ERCP) is a specialized procedure used to study the bile ducts, pancreatic duct, and gallbladder. Bile or biliary ducts are the liver drainage channels and the pancreatic duct is the drainage channel for the pancreas.

How is ERCP performed?

During the procedure, your doctor will pass a thin, flexible tube called an endoscope into the upper part of your gastrointestinal tract, which includes the esophagus, stomach and duodenum (first portion of the small intestine). A tiny video camera at the tip of the tube allows the doctor to see your gastrointestinal tract. After your doctor sees the common opening to the ducts from the liver and pancreas, your doctor will pass a catheter, a narrow plastic tube, through the endoscope and into the ducts. The doctor will inject a dye into the pancreatic or biliary ducts and take x-rays.

What preparation is required?

You will need to fast for six hours prior to your procedure. It is important to have an empty stomach to have the safest and best examination. Your doctor will provide instructions about how to prepare.

What about my medications and allergies?

Notify the doctor of all the medications you are taking. Most medications can be continued as usual, but some medications may need to be adjusted or stopped temporarily prior to the exam. The doctor’s office will discuss any medication changes with you prior to the ERCP.

It is important to inform your doctor of all your allergies including any allergies to intravenous contrast material (dye).

What can I expect during ERCP?

Some patients are given antibiotics prior to the procedure. You will be positioned on your stomach on an x-ray table and the nursing staff will insert a bite block between your teeth for protection during the procedure. You will be given sedation by an anesthesia professional to make you comfortable. The doctor will pass the endoscope through your mouth and into the esophagus, stomach, and duodenum. The endoscope doesn’t interfere with your breathing.

What can I expect after ERCP?

You will be observed for complications until most of the effects of the medications have worn off before being sent home. Your throat might be a little sore and you may have some abdominal bloating from the air introduced into your stomach during the procedure. Unless the doctor instructs otherwise, you may resume a regular diet after you leave.

It can take up to a full day for the effects of the sedation to wear off. Because of the sedation, you will need to have someone to take you home and you are not to go back to work for the rest of the day.

What are possible complications of ERCP?

ERCP is a well-tolerated procedure when performed by doctors who are specially trained and experienced in the procedure. Although complications requiring hospitalization are uncommon, they do occur and can include:

  • Pancreatitis (inflammation of the pancreas)
  • Infections
  • Bowel perforation
  • Bleeding
  • Reactions to sedation

Due to technical reasons, some procedures cannot be completed.

Risks to the procedure vary depending on why the test is being performed, what is found during the procedure, what therapeutic intervention is being done, and patient’s medical history. Therapeutic ERCP, such as for stone removal, has a higher risk of complications than diagnostic ERCP. Your doctor will discuss your risks for complications before the procedure.