Endoscopic Retrograde Cholangiopancreatogram (ERCP) is an examination that combines the use of an endoscope (a flexible, lighted tube) with x-ray technology to examine areas surrounding the liver, gallbladder and pancreas. The ERCP can be used to detect abnormalities from your esophagus to your gallbladder, and if necessary can be used to obtain a biopsy, or tissue sample.
There are several reasons that your physician may recommend an ERCP examination, such as:
- Persistent abdominal pain
- The detection of disease within the liver, bile ducts, or pancreas
- The removal of gallstones
Preparing for the ERCP procedure
When preparing for your ERCP exam, make sure that you notify your doctor of past conditions that may add complications to the procedure such as hay fever, hives, allergies, or asthma. If you are allergic to shell fish it is crucial that you notify your physician, as the iodine used as contrast material for the x-ray may prompt an allergic reaction.
Due to the involvement of the x-ray during an ERCP examination, you should expect to be required to remove all jewelry before undergoing the exam. You will also be required to remove any dentures or contact lenses before the exam begins, in addition to fully emptying your bladder.
What to expect during the ERCP procedure
Your gastroenterologist will conduct your ERCP examination in a hospital setting with the help of an endoscope, a flexible fiber optic tool. There are several uses of an ERCP procedure, including the removal of gallstones. In situations where gallstones are removed during an ERCP, or a stent is inserted into the body an overnight hospital stay will likely be required in order to prevent complication. Otherwise, you will be able to return home after a brief recovery time that generally takes one to two hours. You should expect the ERCP procedure to encompass 30 to 60 minutes.
During the exam, your gastroenterologist will insert an endoscope through your mouth, and will then be gently guided down the throat and into your esophagus, stomach and duodenum until it finally reaches the pancreatic ducts and gallbladder. Your throat will be numbed prior to the entrance of the endoscope to relieve any discomfort, and your teeth will be guarded from the endoscope with a mouth-guard. In addition, you should expect a sedative to be administered via an IV in order to permit relaxation during the exam. Once the endoscope is inserted into your throat, you may be asked to swallow to help expedite the process of the endoscope into your esophagus.
The endoscope will advance until it reaches the papilla area where the ducts from the pancreas and gallbladder drain into the duodenum. Once the endoscope reaches this point a catheter is inserted so that the contrast material necessary for the x-ray can be introduced, after which several x-rays will be taken. If minor complications such as a gallstone are found to be present during the exam, your physician will easily be able to remove them through the endoscope with the use of specialized surgical instruments created for biopsy use.