What is ERCP?
Endoscopic retrograde cholangiopancreatography, or ERCP, is a procedure to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas. It combines X-ray and the use of an endoscope–a long, flexible, lighted tube. Your healthcare provider guides the scope through your mouth and throat, then down the esophagus, stomach, and the first part of the small intestine (duodenum). Your healthcare provider can view the inside of these organs and check for problems. Next, he or she will pass a tube through the scope and inject a dye. This highlights the organs on X-ray.
Why might I need ERCP?
You may need ERCP to find the cause of unexplained abdominal pain or yellowing of the skin and eyes (jaundice). It may be used to get more information if you have pancreatitis or cancer of the liver, pancreas, or bile ducts.
Other things that may be found with ERCP include:
- Blockages or stones in the bile ducts
- Fluid leakage from the bile or pancreatic ducts
- Blockages or narrowing of the pancreatic ducts
- Tumors
- Infection in the bile ducts
What are the risks of ERCP?
If you are pregnant or think you could be, tell your healthcare provider. Radiation exposure during pregnancy may lead to birth defects.
Tell your healthcare provider if you are allergic to or sensitive to medicines, contrast dyes, iodine, or latex.
Some possible complications may include:
- Inflammation of the pancreas (pancreatitis) or gallbladder (cholecystitis). Pancreatitis is one of the most common complications and should be discussed with your provider ahead of time. Keep in mind, though, that ERCP is often performed to help relieve the disease in certain types of pancreatitis.
- Infection
- Bleeding
- A tear in the lining of the upper section of the small intestine, esophagus, or stomach
- Collection of bile outside the biliary system (biloma)
You may not be able to have ERCP if:
- You’ve had gastrointestinal (GI) surgery that has blocked the ducts of the biliary tree
- You have pouches in your esophagus (esophageal diverticula) or other abnormal anatomy that makes the test difficult to perform. Sometimes the ERCP is modified to make it work in these situations.
- You have barium within the intestines from a recent barium procedure since it may interfere with an ERCP
There may be other risks depend based on your condition. Be sure to discuss any concerns with your healthcare provider before the procedure.
How do I get ready for ERCP?
Recommendations for ERCP preparation include the following:
- Your healthcare provider will explain the procedure and you can ask questions.
- You may be asked to sign a consent form that gives your permission to do the test. Read the form carefully and ask questions if something is not clear.
- Tell your healthcare provider if you have ever had a reaction to any contrast dye, or if you are allergic to iodine.
- Tell your healthcare provider if you are sensitive to or are allergic to any medicines, latex, tape, or anesthesia.
- Do not to eat or drink liquids for 8 hours before the procedure. You may be given other instructions about a special diet for 1 to 2 days before the procedure.
- If you are pregnant or think you could be, tell your healthcare provider.
- Tell your healthcare provider of all medicines (prescribed and over-the-counter) and herbal supplements that you are taking.
- Tell your healthcare provider if you have a history of bleeding disorders or if you are taking any blood-thinning medicines (anticoagulants), aspirin, ibuprofen, naproxen, or other medicines that affect blood clotting. You may be told to stop these medicines before the procedure.
- If you have heart valve disease, your healthcare provider may give you antibiotics before the procedure.
- You will be awake during the procedure, but a sedative will be given before the procedure. Depending on the anaesthesia used, you may be completely asleep and not feel anything. You will need someone to drive you home.
- Follow any other instructions your provider gives you to get ready.
What happens after ERCP?
After the procedure, you will be taken to the recovery room. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room or discharged home. If this procedure was done as an outpatient, plan to have someone drive you home.
You will not be allowed to eat or drink anything until your gag reflex has returned. You may have a sore throat and pain with swallowing for a few days. This is normal.
Many times, a rectal suppository of a certain medicine is given after the ERCP to decrease the risk of pancreatitis.
You may go back to your usual diet and activities after the procedure, unless your healthcare provider tells you otherwise.
Tell your healthcare provider if you have any of the following:
- Fever or chills
- Redness, swelling, or bleeding or other drainage from the IV site
- Abdominal pain, nausea, or vomiting
- Black, tarry, or bloody stools
- Trouble swallowing
- Throat or chest pain that worsens
Your healthcare provider may give you other instructions after the procedure, based on your situation.
Important Reminder:
The information provided above is meant to be used as an informative guide for patients. For precise and individualized recommendations, please consult with one of our board certified gastroenterologists to discuss your symptoms.
For additional information or to book an appointment at the Aayushman clinic Gastroenterology Center, please feel free to reach out to our dedicated team by calling us at 8860291508. You can also schedule online or reach out to us via the Contact Us form.