Endoscopic Retrograde Cholangiopancreatography (ERCP)

What is ERCP?

A specialized endoscopy technique to help visualize and study the ducts (drainage tubes) of the gallbaldder, bile ducts, pancreas and liver. An endoscope (a flexible thin tube that allows the physician to see inside the digestive tract) is passed trough the muth into the duodenum (the first part of the small intestine). The opening called the major ampulla that drain both the bile and pancreatic ducts is then identified and a small catheter (narrow plastic tube) is passed through the endoscope into the ducts. Contrast material is then injected into the ducts and x-ray images can be viewed and studied for abnormalities.

Why is ERCP done?

ERCP is a valuable tool that is used for diagnoising many diseases of the pancreas, bile ducts, liver and gallbladder. An example of disorders that can be identified and treated by ERCP include gallstones in the bile ducts, stones in the pancreatic duct, narrowing of the pancreatic or bile ducts called a stricture, jaundice, tumors, pancreatitis, leaks from the bile or pancreatic ducts or to evaluate certain organs and ducts before surgery.

What can ERCP do?

Remove stones stuck or loged in the bile ducts or pancreatic ducts, place plastic or metal stents to alleviate a narrowiing /stricture/tumor of the bile or pancreatic ducts, diagnose diseases of the bile ducts or pancreas, inject medications into the bile or pancreatic ducts and help repair damaged ducts of the bile or pancreatic systems.

Preparing for your ERCP

The test ususally just involves nothing to eat or drink after dinner the night before the examination. ERCP examinations are generally outpatient procedures.

You must leave with an adult after your test

As with any other endoscopy tests, when you have an ERCP, usually you'll receive relaxing medication by vein for your comfort. Since the effects of this relaxing medication can last for a number of hours, you and your driver should plan on being at Scott & White for several hours. It is Scott & White's policy that an adult must accompany you after your procedure as you cannot drive yourself home.

Your procedure will need to be rescheduled if you have not made arrangements to be taken home by another adult. You shoudl likewise not plan to operate any hazardous equipment until the day after your test.

What are the ERCP test risks?

Every test has some risks associated with it and it is important that you are informed of these complications as your doctor will discuss these with you, even if they are quite unusual and rarely occur. There is a chance that you may have a mild sore throat for a day or two after the test or that you may experience some mild bruising or inflammation at the site of your intravenous line. Very rarely, people can have an unexpected reaction to the medication given to relax them for endoscopy examinations.

These reactions can be serious such as slowed breathing, very low blood pressure or having abnormal heart beats. Your blood pressure, heart beat and the amount of oxygen in your blood will be monitored throughout your examination to watch for these problems. You may also receive supplemental oxygen if needed during your test. With ERCP there is a serious risk of pancreatitis which is inflammation of the pancreas. Other rare but serous complications can occur such as, bowel perforation (tear or puncture of the digestive lining), bleeding, infection, and heart or lung problems. These rare, unlikely events could require a surgery or hospitalization.

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