Endoscopic Retrograde Cholangiopancreatogram (ERCP)
How It Is Done
An endoscopic retrograde cholangiopancreatogram (ERCP) is done by a doctor trained in Reference endoscopy Opens New Window, usually a doctor who specializes in diseases of the digestive system (Reference gastroenterologist Opens New Window). A thin, flexible fiber-optic endoscope is used.
ERCP is done in the hospital. You may have to stay overnight if your doctor removes gallstones or places a stent during the test. Otherwise, you will be allowed to go home after the test.
An ERCP usually takes between 30 and 60 minutes. You will be in the recovery room 1 to 2 hours.
Your throat may be numbed with an anesthetic spray, gargle, or lozenge to relax your gag reflex and make it easier to insert the endoscope. Shortly before the test begins, an intravenous (IV) line will be placed in a vein in your arm. You will be given pain medicine and Reference sedative Opens New Window through the IV during the test. You may also be given an antibiotic through the IV.
You will be asked to lie on your left side with your head tilted slightly forward. A mouth guard may be inserted to protect your teeth from the endoscope. The lubricated tip of the endoscope will be guided into your mouth while the doctor gently presses your tongue out of the way. You may be asked to swallow to help move the tube along. The instrument is no thicker than many foods you swallow. Once the endoscope is in your esophagus, your head will be tilted upright to help the scope slide down.
Your doctor will slowly move the endoscope into your stomach and duodenum. Your doctor looks at your esophagus, stomach, and duodenum as the scope moves forward. When the endoscope reaches your duodenum, you will be turned over to lie flat on your abdomen. See a picture of the Reference placement of an endoscope during ERCP Opens New Window Reference Opens New Window.
A small amount of air will be injected through the scope to make it easier for the doctor to see. The endoscope is moved forward until it reaches the point where the ducts from the pancreas and gallbladder drain into the duodenum (the papilla). A thin tube called a catheter is then passed through the endoscope into the papilla, and contrast material is injected into the bile or pancreatic ducts. Several X-rays are taken. You will remain on your abdomen while the X-rays are developed. If necessary, additional X-rays may be taken.
Surgical instruments, called biopsy forceps or brushes, may be inserted through the endoscope to collect samples. If a gallstone is seen during the test, the doctor can sometimes remove it. A narrowed bile duct can be held open by inserting a small wire-mesh or plastic tube called a stent through the endoscope and into the duct.
When the test is completed, the endoscope is slowly withdrawn.
After the test
After the ERCP is completed, you will be observed in a recovery room for 1 to 2 hours. If your throat was numbed before the test, you will not be allowed to eat or drink until your throat is no longer numb and you are able to swallow without choking. You can then resume eating and drinking normally.
Unless you are staying in the hospital, you will need to have someone drive you home after the test. You will not be allowed to drive or to return to work for 24 hours.
Your doctor will make sure you do not have any signs of complications before you go home. If your doctor removed a gallstone or placed a stent during the test, you may need to stay in the hospital overnight.
|By:||Reference Healthwise Staff||Last Revised: Reference April 8, 2011|
|Medical Review:||Reference E. Gregory Thompson, MD - Internal Medicine
Reference Jerome B. Simon, MD, FRCPC, FACP - Gastroenterology