Endoscopic retrograde cholangiopancreatography (ERCP) enables your physician to diagnose problems in the liver, gallbladder, bile ducts, and pancreas. ERCP is used primarily to diagnose and treat conditions of the bile ducts, including gallstones, narrowing or strictures (scars), leaks (from trauma and surgery), and cancer; as well as the pancreas, including stones, narrowing or strictures, and cancer. ERCP combines the use of x-rays and an endoscope, which is a long, flexible, lighted tube. Through the endoscope, the physician can see the inside of the stomach and duodenum, and inject dyes into the ducts in the biliary tree and pancreas so they can be seen on x-ray.
What to Expect
For the procedure, you will lie on your left side on an examining table in an X-ray room. You may be given medication to help numb the back of your throat and a sedative to help you relax during the exam. The endoscope will be passed into your esophagus, and the physician will then guide the scope through your esophagus, stomach, and duodenum until it reaches the spot where the ducts of the biliary tree and pancreas open into the duodenum. At this time, you will be turned to lie flat on your stomach, and the physician will pass a small plastic tube through the scope. Through this tube or cannula, the physician will inject a dye into the ducts to make them show up clearly on X-ray.
If the exam shows a gallstone or narrowing of the ducts, the physician can insert instruments through the scope to remove or relieve the obstruction. Also, tissue samples (biopsy) can be taken for further testing.
ERCP takes 30 minutes to 2 hours. The pain medicine and sedative administered prior to your procedure should keep you from feeling any discomfort. After the procedure, you will need to stay at the hospital for 1 to 2 hours until the sedative wears off. On rare occasions, if certain kinds of treatments are done during your procedure, you may need to stay in the hospital overnight.
How to Prepare
Your stomach and duodenum must be empty for the procedure to be accurate and safe. You will not be able to eat anything after midnight the night before the procedure, or for 8 hours beforehand, depending on the time of your procedure. You may have clear liquids up to 3 hours prior to the procedure. Also, your physician will need to know whether you have any allergies, especially to iodine, which is in the dye. You will be given a sedative prior to your procedure and, therefore, will not be able to drive. You will need to arrange for someone to take you home.