What is Endoscopic Retrograde Cholangiopancreatography (ERCP)?

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a procedure that combines upper gastrointestinal endoscopy and X-rays to identify and treat medical problems involving the gallbladder, bile ducts, pancreas, and liver.

What is the purpose of an ERCP?

The ERCP procedure is used to identify and treat biliary and pancreatic diseases. Non-invasive procedures such as MRI are preferable for diagnosis alone. When the bile or pancreatic ducts get blocked as a consequence of:

  • Gallstones
  • Pancreatitis, both acute and chronic
  • Bile Duct Cancer
  • Pancreatic Cancer
  • Pancreatic Pseudocysts

How to prepare for an ERCP?

It is important to discuss all the medications currently being used by the patient including vitamin and mineral supplements, medications for arthritis, diabetes, blood pressure, NSAIDs, etc. Your doctor may advise you to temporarily discontinue drugs that interact with sedatives.

Prior to the treatment, the doctor would also give the patient the following instructions:

  • Do not eat or drink anything 8 hours prior to the procedure
  • Do not smoke

How is it performed?

Once the sedative is given an endoscope is carefully inserted down his or her esophagus, through the stomach & into the duodenum. The doctor next inserts the catheter into the duodenum where the bile and pancreatic ducts open. The doctor then injects a contrast medium into the ducts to make them more visible. Fluoroscopy is used to examine the ducts and locate any obstructions.

To unclog restricted or obstructed ducts, certain equipment may be added to the endoscope.

  • Stones should be removed.
  • Collect tissue sample
  • Stents should be placed.
  • The ERCP process usually takes 1 to 2 hours.

Since ERCP is an outpatient procedure, the patient would be allowed to go home once the sedative wears off. The patient will almost never be needed to remain overnight. Bloating or nausea may occur after the ERCP, as well as a sore throat for a day or two.

What are the possible risks of ERCP?

  • Pancreatitis
  • Bile or pancreatic duct infections
  • Excessive bleeding
  • Tissue damage

After the Procedure

  • It may take up to an hour for patients to recover from the sedative. If a polyp was removed during the colonoscopy, a specific diet may be prescribed for a week. For a few hours after the surgery, the patient may feel bloated or have gas. There may be some blood in your first stool following the surgery in certain situations. However, if you continue to pass blood in your stools or have a prolonged fever or abdominal discomfort, get quick medical attention.

  • If the colonoscopy results are negative, it means that there are no abnormalities in the large intestine. In such cases, the doctor may recommend another colonoscopy in 10 years, if there are no risk factors other than age. If the patient has a history of polyps, the doctor may request that the surgery be repeated in 5 years.

  • If the result is positive, that means an abnormal tissue or polyps was found during the procedure. In such circumstances, a second colonoscopy may be necessary for 5-10 years, depending on the patient's other risk factors.

To learn more about ERCP consult Dr. Vedanr Karvir one of the top Gastroenterologist in Kandivali.


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