What Is Endoscopic Retrograde Cholangiopancreatography?
Endoscopic retrograde cholangiopancreatography, or ERCP, is a diagnostic procedure performed in order to observe the bile ducts, gallbladder, and pancreatic duct and detect any abnormalities. Simply put, a duct is a drainage tube and in the human body, there are ducts that drain the liver, pancreas, and gallbladder. These ducts are slender and flexible but difficult to study without a specialized procedure. In order to observe these ducts, ERCP combines an endoscope with an X-ray. This provides a detailed view of the ducts. In addition, the endoscope allows our Concorde Gastroenterology physicians to remove bile duct obstructions including stones, tumors, or strictures.
Why Do I need an ERCP?
An ERCP detects, diagnoses, and treats abnormalities along the gastrointestinal tract. Patients that are experiencing any of the following symptoms may need an ERCP.
- Loss of appetite
- Sudden, unexplained weight loss
- Darkened urine
- Severe abdominal pains
- Light-colored stools
Prior to the ERCP your physician will provide you with instructions about fasting and take a detailed medical history. Discuss all medications you take, both prescription and over the counter, especially any blood thinners, herbal supplements, and aspirin. Make sure you disclose any other important medical conditions such as diabetes, heart, or lung conditions. Your doctor should also be aware of any allergies you may have, particularly to any contrast medications you may have had in the past. Before the ERCP any necessary diagnostic imaging tests will be complete in order to aid your physician in pinpointing the problem. For more information, see our ERCP preparation instructions.
The Endoscopic Retrograde Cholangiopancreatography Procedure
To start, patients will be given IV sedation and numbing medication in their throat to make the procedure comfortable. Be sure to have someone accompany you to and from your procedure as well as attend to you at home. The anesthesia can have an effect on you for the rest of day and for your safety we ask that you not be alone. Then, your doctor will insert the endoscope through the mouth and into the duodenum, the uppermost part of the small intestine. Next, we will insert a catheter into the endoscope. This allows access to the pancreas and gallbladder. Additionally, our physicians will inject a dye which increases the visibility of the ducts and take x-rays of the area.
If our physicians see anything through the endoscope or catheter they can also perform minor surgery at the time of the ERCP. These procedures, if necessary may extend the total length of the procedure from 30 minutes up to about 2 hours. These minor procedures include:
- Removing tissue for biopsy
- Removing abnormal growths
- Crushing or removing gallstones
- Widening the bile duct with a stent
- Draining the bile duct or other blocked areas
- Diagnosing disease conditions including biliary cirrhosis and sclerosing cholangitis
An ERCP is a safe procedure, but is best handled by an experienced gastroenterologist. The delicate nature of the bile ducts requires an expert hand. Our physicians at Concorde Gastroenterology are specially trained, highly qualified specialists and have the experience you can trust.
Risks of ERCP
Prior to the ERCP, your physician will discuss the complications and risks. Complications are rare but can occur. The most common complaint is slight bloating or gas pains from air being introduced into your system during the procedure. These pains resolve themselves over time. Additionally, patients can experience infection, excessive bleeding, pancreatitis, a reaction to the anesthesia, dye, or medication, or perforation of the bowel. In order to monitor these risks, patients will remain in recovery during and after they wake from the anesthesia. Your doctor will give you instructions on resuming your normal activities, including eating after your ERCP is complete.