ERCP - Endoscopic Retrograde CholangioPancreatography


Endoscopic retrograde cholangiopancreatography is procedurethat combine upper gastr-intestinal (GI) endoscopy and x rays to treat problems of the bile and pancreatic ducts.

How does a person prepare for ERCP?

The upper G.I. tract must be empty. Generally, no eating or drinking is allowed eight hours before ERCP. Smoking and chewing gum are also prohibited during this time. Patients should tell their health care provider if they have heart and lung problems, diabetes, and allergies. Patient may be asked to temporarily stop taking medications that affect blood clotting or interact with sedatives.

Medications and vitamins that may be restricted before and after ERCP include: Nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen (Advil), and naproxen (Aleve).
Blood thinners
High blood pressure medication
Diabetes medications
Dietary supplements

Driving is not permitted for 12 to 24 hours after ERCP to allow the sedatives time to completely wear off.

How is ERCP performed?

Patients receive a local anesthetic that numbs the throat and calms the gag reflex. An intravenous needle is inserted into a vein in the arm if sedatives will be given.

An endoscope is inserted down the esophagus, through the stomach, and into the duodenum. Video is transmitted from a small camera attached to the endoscope to a computer screen. Air is pumped through the endoscope to inflate the stomach and duodenum, making them easier for the doctor to examine.

A Catheter is slid through the endoscope and guided through the papillary opening so the doctor can inject a dye into the ducts. This allows the ducts to be seen on x-rays to identify and treat narrowed areas of blockages. Treatment can include opening blocked ducts, breaking up or removing gallstones, removing tumors is the ducts, or inserting stents. A kind of biopsy called brush cytology allows the doctor to remove cells from inside the ducts using a brush. The collected cells are later examined with a microscope for signs of infection or cancer.

What does recovery from ERCP involve?

In recovery, it takes about an hour for the sedatives to wear off. During this time, patients may feel bloated or nauseous and may also have a sore throat, which can last a day or two. Patients will likely feel tired and should plan to rest for the remainder of the day.