ERCP (Endoscopic Retrograde Cholangiopancreatography)
ERCP is used to study the ducts (drainage routes) of the gallbladder, pancreas and liver. An endoscope (flexible thin tube that allows the physician to see inside the bowel) is passed through the mouth, esophagus and stomach into the duodenum (first part of the small intestine). After the common opening to ducts from the liver and pancreas is visually identified, a catheter (narrow plastic tube) is passed through the endoscope into the ducts. Contrast material (dye) is then injected gently into the ducts and X-ray films are taken.
What can be expected during ERCP?
Your physician will discuss why ERCP is being performed, potential complications, and alternative diagnostic or therapeutic tests that are available. A local anesthetic may be applied to your throat and an intravenous sedative may be given to make you more comfortable during the test. Some patients also receive antibiotics before the procedure.
The test begins with you lying on your left side on an X-ray table. The endoscope is passed through the mouth, esophagus and stomach into the duodenum. The instrument does not interfere with breathing. Air is introduced through the instrument and may cause temporary bloating during and after the procedure. The injection of contrast material into the ducts rarely causes discomfort.
What are possible complications of ERCP?
ERCP is generally a well-tolerated procedure. On rare occasions localized irritation of the vein into which medications were given cause a tender lump that may last several weeks. The application of heat packs or hot, moist towels to the area may ease the discomfort.
Major complications requiring hospitalization can occur but are uncommon. They include serious pancreatitis, and even more rarely infections, bowel perforation and bleeding. Another potential risk is an adverse reaction to the sedative used.
The risks of the procedure vary with the indications for the test, what is found during the procedure, what therapeutic intervention is undertaken, and the presence of other major medical problems such as heart or lung diseases. Your physician will discuss your likelihood of complications before undergoing the test.
If therapeutic ERCP is performed (cutting an opening in the bile duct, stone removal, dilation of a stricture, stent or drain replacement, etc.), the possibility of complications is higher than with diagnostic ERCP. Complications include pancreatitis, bleeding, and bowel perforation. These risks must be balanced against the potential benefits of the procedure and the risks of alternative surgical treatment of the condition. Often these complications can be managed, but occasionally they do require corrective surgery.
What can be expected following ERCP?
If you are having ERCP as an outpatient, you will be kept under observation until most of the effects of the medications have worn off. Evidence of any complications will be looked for and hospitalization may be advised if further observation is necessary.
You may experience bloating or pass gas because of the air introduced during the examination. You may resume your usual diet unless you are instructed otherwise.
