What is Endoscopic Retrograde Cholangiopancreatogram (ERCP)
Endoscopic retrograde cholangiopancreatogram is a procedure that may be used to diagnose or treat problems with the pancreas, bile ducts, liver, and gallbladder.
For this procedure, a thin, lighted tube (endoscope) is passed through the mouth, the throat, and down into the areas being checked. The endoscope has a camera that allows the areas to be viewed. Dye is injected and then X-rays are taken to further study the areas.
During ERCP, other procedures may also be done to help diagnose or treat problems that are found. For example, stones can be removed, or a tissue sample can be taken out for testing (biopsy).
Tell a health care provider about:
- Any allergies you have.
- All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
- Any problems you or family members have had with anesthetic medicines.
- Any blood disorders you have.
- Any surgeries you have had.
- Any medical conditions you have.
- Whether you are pregnant or may be pregnant.
What are the risks?
Generally, this is a safe procedure. However, problems may occur, including:
- Pancreatitis.
- Infection.
- Bleeding.
- Allergic reactions to medicines or dyes.
- Accidental punctures in the bowel wall, pancreas, or gallbladder.
- Damage to other structures or organs.
What happens before the procedure?
Staying hydrated
Follow instructions from your health care provider about hydration, which may include:
- Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.
Eating and drinking restrictions
Follow instructions from your health care provider about eating and drinking, which may include:
- 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
- 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
- 6 hours before the procedure – stop drinking milk or drinks that contain milk.
- 2 hours before the procedure – stop drinking clear liquids.
General instructions
- Ask
your health care provider about:
- Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
- Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do nottake these medicines before your procedure if your health care provider instructs you not to.
- Plan to have someone take you home from the hospital or clinic.
- If you will be going home right after the procedure, plan to have someone with you for 24 hours.
What happens during the procedure?
- To lower your risk of infection, your health care team will wash or sanitize their hands.
- An IV tube will be inserted into one of your veins.
- You
will be given one or more of the following:
- A medicine to help you relax (sedative).
- A medicine to numb the throat area (local anesthetic) and prevent gagging. Your throat may be sprayed with this medicine, or you may gargle the medicine.
- A medicine to make you fall asleep (general anesthetic).
- A medicine to lower your risk of infection (antibiotic), inflammation (anti-inflammatory), or both.
- You will lie on your left side.
- The endoscope will be inserted through your mouth, down the back of the throat, and into the first part of the small intestine (duodenum).
- Then a small, plastic tube (cannula) will be passed through the endoscope and directed into the bile duct or pancreatic duct.
- Dye will be injected through the cannula to make structures easier to see on an X-ray.
- X-rays will be taken to study the biliary and pancreatic passageways. You may be positioned on your abdomen or your back during the X-rays.
- A small sample of tissue (biopsy) may be removed for examination, or other procedures may be done to fix problems that are found.
The procedure may vary among health care providers and hospitals.
What happens after the procedure?
- Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
- Your throat may feel slightly sore.
- You will not be allowed to eat or drink until numbness subsides.
- Do notdrive for 24 hours if you were given a sedative.
Summary
- Endoscopic retrograde cholangiopancreatogram is a procedure that may be used to diagnose or treat problems with the pancreas, bile ducts, liver, and gallbladder.
- During ERCP, other procedures may also be done to help diagnose or treat problems that are found. For example, stones can be removed, or a tissue sample can be taken out for testing (biopsy).
- Generally, this is a safe procedure. However, problems may occur, including infection, bleeding, pancreatitis, accidental damage to other structures or organs, and allergic reactions to medicines or dyes.
- The procedure may vary among health care providers and hospitals.
Endoscopic Retrograde Cholangiopancreatogram, Care After
This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.
What can I expect after the procedure?
After the procedure, it is common to have:
- Soreness in your throat.
- Nausea.
- Bloating.
- Dizziness.
- Tiredness (fatigue).
Follow these instructions at home:
- Take over-the-counter and prescription medicines only as told by your health care provider.
- Do notdrive for 24 hours if you were given a medicine to help you relax (sedative) during your procedure. Have someone stay with you for 24 hours after the procedure.
- Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
- Return to eating what you normally do as soon as you feel well enough or as told by your health care provider.
Keep all follow-up visits as told by your health care provider. This is important.
Contact a health care provider if:
- You have pain in your abdomen that does not get better with medicine.
- You
develop signs of infection, such as:
- Chills.
- Feeling unwell.
Get help right away if:
- You have difficulty swallowing.
- You have worsening pain in your throat, chest, or abdomen.
- You vomit bright red blood or a substance that looks like coffee grounds.
- You have bloody or very black stools.
- You have a fever.
- You have a sudden increase in swelling (bloating) in your abdomen.
Summary
- After the procedure, it is common to feel tired and to have some discomfort in your throat.
- Contact your health care provider if you have signs of infection—such as chills or feeling unwell—or if you have pain that does not improve with medicine.
- Get help right away if you have trouble swallowing, worsening pain, bloody or black vomit, bloody or black stools, a fever, or increased swelling in your abdomen.
- Keep all follow-up visits as told by your health care provider. This is important.
