What is ERCP?
Endoscopic retrograde cholangiopancreatography, or ERCP,
is a specialized technique used to study the ducts of the gallbladder,
pancreas and liver. Ducts are drainage routes; the drainage channels
from the liver are called bile or biliary ducts. If your doctor has
recommended an ERCP, this brochure will give you a basic understanding
of the procedure - how it's performed, how it can help, and what side
effects you might experience. It can't answer all of your questions,
since a lot depends on the individual patient and the doctor. Please
ask you doctor about anything you don't understand. During ERCP, your
doctor will pass an endoscope through your mouth, esophagus and stomach
into the duodenum (first part of the small intestine). An endoscope
is a thin, flexible tube that lets your doctor see inside your bowels.
After your doctor sees the common opening to ducts from the liver
and pancreas, your doctor will pass a narrow plastic tube called a
catheter through the endoscope and into the ducts. Your doctor will
inject a contrast material (dye) into the pancreatic or biliary ducts
and will take X-rays.
What preparation is required?
You should fast for at least six hours (and preferably overnight)
before the procedure to make sure you have an empty stomach, which
is necessary for the best examination. Your doctor will give you precise
instructions about how to prepare. You should talk to your doctor
about medications you take regularly and any allergies you have to
medications, or intravenous contrast material. Although an allergy
doesn't prevent you from having ERCP, it's important to discuss it
with your doctor prior to the procedure.
Also, be sure to tell your doctor if you have heart or lung conditions,
or other major diseases.
What can I expect during ERCP?
Your doctor might apply a local anesthetic to your throat or give
you a sedative to make you more comfortable. Some patients also receive
antibiotics before the procedure. You will lie on your left side on
an X-ray table. Your doctor will pass the endoscope through your mouth,
esophagus, stomach and into the duodenum. The instrument does not
interfere with breathing, but you might feel a bloating sensation
because of the air introduced through the instrument.
What are possible complications of ERCP?
ERCP is a well-tolerated procedure when performed by doctors who are
specially trained and experienced in the technique. Although complications
requiring hospitalization can occur, they are uncommon. Complications
can include pancreatitis (an inflammation or infection of the pancreas),
infections, bowel perforation and bleeding. Some patients can have
an adverse reaction to the sedative used. Sometimes the procedure
cannot be completed for technical reasons. Risks vary, depending on
why the test is performed, what is found during the procedure, what
therapeutic intervention is undertaken, and whether a patient has
major medical problems. Patients undergoing therapeutic ERCP, such
as for stone removal, face a higher risk of complications than patients
undergoing diagnostic ERCP. Your doctor will discuss your likelihood
of complications before you undergo the test.
What can I expect after ERCP?
If you have ERCP as an outpatient, you will be observed for
complications until most of the effects of the medications have worn
off. You might experience bloating or pass gas because of the air
introduced during the examination. You can resume your usual diet
unless you are instructed otherwise. Someone must accompany you home
from the procedure because of the sedatives used during the examination.
Even if you feel alert after the procedure, the sedatives can affect
your judgment and reflexes for the rest of the day. ASGE Patient Education
brochures are available for purchase in packs of 50. Download order
Please contact your doctor promptly if you have any follow-up questions
or if you are experiencing any complications due to the procedure.
ASGE - The Source for Colonoscopy and Endoscopy
The preceding information is intended only to provide general information
and not as a definitive basis for diagnosis or treatment in any particular
case. It is very important that you consult your doctor about your