Endoscopic Retrograde Cholangiopancreatography (ERCP)
Endoscopic retrograde cholangiopancreatography (ERCP) is a specialized procedure that combines the use of x-rays and an endoscope, which is a long, thin, flexible tube with a light and a camera on its tip. With ERCP, your doctor can diagnose problems in the liver, gallbladder, bile ducts and pancreas. Mainly, however, this method is used to diagnose and treat conditions of the bile ducts, including gallstones, strictures, leaks (from trauma and surgery) and cancer.
- When abnormal growths are found, doctors can insert an instrument through the endoscope to obtain a tissue sample for testing (biopsy).
- If a gallstone is present in the common bile duct, doctors can sometimes remove the stone with instruments inserted through the endoscope.
- If a bile duct has become too narrow, doctors can enlarge it by making a small cut, and then inserting a small wire mesh or plastic tube through the endoscope and into the duct.
During the ERCP Procedure
The endoscope will be inserted through your mouth and gently moved down the throat into the esophagus, stomach and first part of the small intestine (duodenum), until it reaches the point where the ducts from the pancreas (pancreatic ducts) and gallbladder (bile ducts) drain bile into the duodenum.
After the doctor has seen the common opening to the ducts from the liver and pancreas (the major duodenal papilla), a narrow plastic tube (catheter) will be passed through the endoscope into the ducts. At that point, the doctor will inject a contrast material or dye into the duct(s) and take some X-rays.
After the ERCP Procedure
If you had the procedure on an outpatient basis, you will be allowed to go home after you recover from most of the effects of sedating medication.
You may feel bloated temporarily or pass some gas due to air that entered your body during the procedure.
Possible Complications of ERCP
Complications from ERCP are not common, although it’s important to have the procedure done by a doctor who has special training and experience in ERCP. Possible complications include:
- Pancreatitis (an inflamed or irritated pancreas)
- Bowel perforation
- Adverse reaction from the sedative
The risks depend in part on the type of ERCP that is done, what the doctor finds during the examination, the patient’s general health, and the type of therapy that is done during the procedure. If you are having ERCP performed for removal of stones, for example, you have a greater risk of complications than for people who have diagnostic ERCP done. Your doctor can tell you about your specific risks before you have ERCP.
Where Is ERCP Performed?
Palo Alto Medical Foundation offers a state-of-the-art endoscopy testing facility to screen for gastrointestinal problems. We operate with a highly-trained support staff of nurses and surgical technicians. These procedures are technically complex and require specialized equipment, so they are done in the hospital.