ERCP - (Endoscopic Retrograde Cholangiopancreatography)

1. General
2. The Procedure
3. Post Procedure
4. Discharge Instructions

1. General

• Endoscopic retrograde cholangiopancreatography (ERCP) is used to diagnose problems in the liver, gallbladder, bile ducts, and pancreas
  
  
• The liver is a large organ that, among other things, makes a liquid called bile that helps with digestion
  
  
• The gallbladder is a small, pear-shaped organ that stores bile until it is needed for digestion
  
  
• The bile ducts are tubes that carry bile from the liver to the gallbladder and small intestine. These ducts are sometimes called the biliary tree
  
  
• The pancreas is a large gland that produces chemicals that help with digestion and hormones such as insulin
  
  
• ERCP is used primarily to diagnose and treat conditions of the bile ducts including gallstones, inflammatory strictures (scars), leaks(from trauma and surgery), and cancer
  
  
• ERCP combines the use of x rays and an endoscope, which is a long, flexible, lighted tube. Through it, the doctor can see the inside of the stomach and duodenum, and inject dyes into the ducts in the biliary tree and pancreas so they can be seen on x rays
  
  
• You will not be able to eat or drink anything after midnight the night before the procedure, or for 6 to 8 hours beforehand
  
  
• The doctor will need to know whether you have any allergies, especially to iodine, which is in the dye
  
  
• Please ask your doctor about any possible risks or complications before the procedure

2. The Procedure

• ERCP takes 30 minutes to 2 hours
  
  
• For the procedure, you will lie on your left side on an examining table in an x ray room
  
  
• 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 swallow the endoscope, and the doctor will then guide the scope through your oesophagus, stomach, and duodenum until it reaches the spot where the ducts of the biliary tree and pancreas open into the duodenum
  
  
• At this time, you will be turned to lie flat on your stomach, and the physician will pass a small plastic tube through the scope
  
  
• 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
  
  
• You may have some discomfort when the physician blows air into the duodenum and injects the dye into the ducts
  
  
• The pain medicine and sedative should keep you from feeling too much discomfort

3. Post Procedure

• After the procedure, you will need to stay at the hospital for 1 to 2 hours until the sedative wears off
  
  
• If any kind of treatment is done during ERCP, such as removing a gallstone, you may need to stay in the hospital overnight
  
  
• The dye will pass out of your system harmlessly
  
  
• Possible complications of ERCP include pancreatitis (inflammation of the pancreas), infection, bleeding, and perforation of the duodenum
  
  
• You may have tenderness or a lump where the sedative was injected, but that should go away in a few days

4. Discharge Instructions

• You must also arrange for someone to take you home, you will not be allowed to drive because of the sedatives
  
  
• You should be back to normal by the next day
  
  
• Be sure to call your doctor if you experience fever or chills or persistent pain