Learn about ERCP from the doctors of Associated Gastroenterology

Endoscopic retrograde cholangiopancreatography, or ERCP, is an endoscopic procedure that is used to examine and treat problems in the bile and pancreatic ducts, and the gallbladder. This procedure is often performed in patients with gallstones, abdominal pain, jaundice (yellowing or the eyes or skin), inflammation of the pancreas or pancreatic cancer. The doctors at AGMG are highly skilled at performing this technical procedure which uses both a live video and x-ray images to treat disorders of the pancreas and bile ducts.

Why is ERCP performed?

ERCP can be performed for a number of reasons. ERCP can see if there is a blockage or narrowing in your bile or pancreatic ducts caused by stones, tumors, or scarring. If any obstruction is found, tools can be passed through to relieve a block such as placement of a stent. If there are stones (a common cause of pain), then the stones can be removed using balloons and baskets. In addition, ERCP can help find the cause of pancreatitis (inflammation of the pancreas) and even to prevent future attacks.

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How is ERCP performed:

ERCP is an endoscopic procedure that uses a flexible instrument called a duodenoscope.
Steps that your doctor will perform:

  • The duodenoscope is passed through the mouth, stomach and into the small intestine. The opening of the bile duct and pancreatic duct are in the first part of the small intestine.
  • Using the camera and x-ray, the doctor will pass a thin catheter through the opening of the ducts called the papilla into either the bile duct, pancreatic duct or both
  • Dye is injected through the catheter to obtain an x-ray image to see if there are any abnormalities of the duct
  • At this point, depending on the finding - the doctor may make a small cut in the opening, remove stones or even place a stent

ERCP is a highly technical procedure and can last anywhere from 30 minutes to 3 hours depending on the patient and the reason for the procedure.

How do I prepare for an ERCP?

ERCP is typically performed in the hospital but as an outpatient. Confirm with the AGMG office staff if you have any questions about the location or time of your procedure
Nothing to eat or drink after midnight on the day before your procedure
You should discuss all current medications with your doctor, as some may need to be adjusted or temporarily stopped prior to the procedure. This step is especially important if you are taking aspirin, blood thinners (warfarin or heparin), clopidogrel, nonsteroidal anti-inflammatory drugs (NSAIDs), insulin, or other medicines for diabetes
It is also important to discuss any medication allergies, including those to iodine or intravenous (IV) contrast dye.

Frequently Asked Questions

Do you have to be put to sleep for a ERCP?

Yes, because ERCP is a very technical procedure sedation is required in order to ensure the safety of the patient. The anesthesiologist will decided if you need sedation or general anesthesia (breathing tube) prior to your procedure depending on your medical history.
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What are the side effects of a ERCP?

Because the bile and pancreatic ducts run through the pancreas, there is a risk of inflammation of the pancreas with ERCP. This is called post ERCP pancreatitis. Your doctor will take every step to limit this well known risk. Other side effects are rare including bleeding.