Understanding
ERCP
What
is ERCP?
Endoscopic retrograde cholangiopancreatography, or ERCP,
is a specialized technique used to study the ducts of the
gallbladder, pancreas and liver. Ducts are drainage
routes; the drainage channels from the liver are called
bile or biliary ducts. If your doctor has recommended an
ERCP, this brochure will give you a basic understanding of
the procedure - how it's performed, how it can help, and
what side effects you might experience. It can't answer
all of your questions, since a lot depends on the
individual patient and the doctor. Please ask you doctor
about anything you don't understand.
During
ERCP, your doctor will pass an endoscope through your
mouth, esophagus and stomach into the duodenum (first part
of the small intestine). An endoscope is a thin, flexible
tube that lets your doctor see inside your bowels. After
your doctor sees the common opening to ducts from the
liver and pancreas, your doctor will pass a narrow plastic
tube called a catheter through the endoscope and into the
ducts. Your doctor will inject a contrast material (dye)
into the pancreatic or biliary ducts and will take X-rays.
What
preparation is required?
You should fast for at least six hours (and preferably
overnight) before the procedure to make sure you have an
empty stomach, which is necessary for the best
examination. Your doctor will give you precise
instructions about how to prepare.
You
should talk to your doctor about medications you take
regularly and any allergies you have to medications, or
intravenous contrast material. Although an allergy doesn't
prevent you from having ERCP, it's important to discuss it
with your doctor prior to the procedure.
Also,
be sure to tell your doctor if you have heart or lung
conditions, or other major diseases.
What
can I expect during ERCP?
Your doctor might apply a local anesthetic to your throat
or give you a sedative to make you more comfortable. Some
patients also receive antibiotics before the procedure.
You will lie on your left side on an X-ray table. Your
doctor will pass the endoscope through your mouth,
esophagus, stomach and into the duodenum. The instrument
does not interfere with breathing, but you might feel a
bloating sensation because of the air introduced through
the instrument.
What
are possible complications of ERCP?
ERCP is a well-tolerated procedure when performed by
doctors who are specially trained and experienced in the
technique. Although complications requiring
hospitalization can occur, they are uncommon.
Complications can include pancreatitis (an inflammation or
infection of the pancreas), infections, bowel perforation
and bleeding. Some patients can have an adverse reaction
to the sedative used. Sometimes the procedure cannot be
completed for technical reasons.
Risks
vary, depending on why the test is performed, what is
found during the procedure, what therapeutic intervention
is undertaken, and whether a patient has major medical
problems. Patients undergoing therapeutic ERCP, such as
for stone removal, face a higher risk of complications
than patients undergoing diagnostic ERCP. Your doctor will
discuss your likelihood of complications before you
undergo the test.
What
can I expect after ERCP?
If you have ERCP as an outpatient, you will be observed
for complications until most of the effects of the
medications have worn off. You might experience bloating
or pass gas because of the air introduced during the
examination. You can resume your usual diet unless you are
instructed otherwise.
Someone
must accompany you home from the procedure because of the
sedatives used during the examination. Even if you feel
alert after the procedure, the sedatives can affect your
judgment and reflexes for the rest of the day.
