What is an endoscopic retrograde cholangio-pancreatography (ERCP)?

An ERCP is a procedure that combines upper gastrointestinal (GI) endoscopy and x-rays to treat and diagnose problems in the bile and pancreatic ducts.

An ERCP takes around 30 to 60 minutes. It’s performed while you are under sedation and your throat will be anesthetized before the endoscope is inserted into your mouth. The endoscope is then pushed down through your esophagus and stomach, and then into the small intestine until it reaches the drainage point for the pancreatic and bile ducts.

At this stage, a catheter is inserted through the endoscope in order to inject a contrast medium into the bile or pancreatic duct. This solution improves the visibility of the ducts when the x-rays are taken. A type of x-ray imaging called fluoroscopy will then be used to examine the ducts. Other instruments can be inserted thought the endoscope to break up or remove blockages, place stents, and take tissue samples.

You will be asked not to eat, drink, smoke or chew gum for several hours beforehand, and your physician may also advise you to stop taking certain medications.

It’s common to have a sore throat for a day or two afterwards and a little nausea or bloating for a few hours. It these symptoms don’t resolve, or you experience vomiting, new or more severe abdominal pain, black or bloody stools, dizziness, fever, chest pain or shortness of breath, contact a doctor immediately.

You will usually be able to go home an hour or two after your ERCP, but if you have had general anesthesia or had a stone removed, you may need to stay in overnight.

Who needs an endoscopic retrograde cholangio-pancreatography (ERCP)?

An ERCP may be recommended if:

  • a tissue sample is required
  • you need a drain inserted
  • you have chronic jaundice or abdominal pain
  • you have a narrowed or blocked pancreatic duct or bile duct due to:
    • gallstones
    • tumors
    • infection
    • acute or chronic pancreatitis, or inflammation due to illness or trauma
    • scarring (sclerosis)
    • build-up of tissue or debris
    • pancreatic pseudocysts
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