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Endoscopic Retrograde Cholangiopancreatography (ERCP)

Endoscopic retrograde cholangiopancreatography (ERCP) is performed by using x-rays in combination with a long, flexible, lighted viewing instrument (duodenoscope) about the diameter of a pen. Through the duodenoscope, the physician can see the inside of the stomach and duodenum, and inject dyes into the bile ducts so that the pancreas, gall bladder, liver, and small intestine can be seen on x rays.

enables the physician to diagnose problems in the liver, gallbladder, bile ducts, and pancreas. The duodenoscope is flexible and can be directed and moved around the many bends of the stomach and intestine.

ERCP is used primarily to diagnose and treat conditions of the bile ducts including:

  • Gallstones
  • Inflammatory strictures (scars)
  • Leaks (from trauma and surgery)
  • Cancer

How do I prepare?

Your stomach and duodenum must be empty for the procedure to be accurate and safe. You will not be able to eat or drink anything after midnight the night before the procedure, or for 6 to 8 hours beforehand, depending on the time of your procedure. Your physician may give you other special instructions as well.

What happens during and after the procedure?

During the procedure,with the patient lying on his/her left side, the physician places a mouthpiece in the patient’s mouth. The physician then inserts a duodenoscope into the mouth, through the esophagus, the stomach, and the duodenum, until it reaches the spot where the bile ducts open into the small intestine. At this time, the patient is turned to lie flat on the stomach, and the physician passes a small plastic tube through the duodenoscope. Through the tube, the physician will inject a dye into the ducts to make them show up clearly on x rays. X rays are taken as soon as the dye is injected.

If the exam shows a gallstone or narrowing of the ducts, the physician can insert instruments into the scope to remove or relieve the obstruction. Tissue samples (biopsy) can be taken for further testing. ERCP takes 30 minutes to 2 hours.

ERCP is performed with sedation. You will be given medication to help numb the back of your throat and a sedative to help you relax during the exam. You will not be able to return to work or to drive for 24 hours following the procedure. You will need someone to take you home following the procedure. The sedation given during the procedure causes drowsiness and dizziness, and impairs your judgment, making it unsafe for you to drive or operate machinery.

Your physician will make sure you do not have signs of complications before you leave. If any kind of treatment is done during ERCP, such as removing a gallstone, you may need to stay in the hospital overnight.

You may have some discomfort when the physician blows air into the duodenum and injects the dye into the ducts. However, the pain medicine and sedative should keep you from feeling too much discomfort.

Following the procedure, you may experience temporary soreness in your throat or bloating in the stomach/intestine, which will quickly dissipate. Throat lozenges and/or ice can help to relieve any sore throat discomfort.

 
       
 

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