Endoscopic Retrograde Cholangiopancreatography (ERCP)

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Endoscopic Retrograde Cholangiopancreatography (ERCP)

This is a test which examines your liver, pancreas, gallbladder, and bile ducts. The physician uses a small, flexible tube, which has a light on it to examine these organs. During this procedure the physician will also take x-rays. They may inject a contrast dye intravenously in order to highlight these areas on the x-rays. This procedure is performed to diagnosis and treat problems with the bile ducts. Bile ducts connect the liver, pancreas, gallbladder, and small intestine.In preparation for an ERCP you will not be able to eat or drink for 6-8 hours prior to the procedure. You need to tell the physician or staff if you have ever had a reaction to any medicines or iodine, which is used in the contrast dye.

This procedure can be performed in a hospital or outpatient clinic, depending on your physician’s preference. This procedure is performed under general anesthesia. The back of your throat may be sprayed with a local anesthetic to prevent gagging or choking during the procedure. The physician will insert a tube in your mouth, down your throat, and through the esophagus and into the stomach and small intestine until it reaches the sphincter of Oddi. The sphincter of Oddi is the place where the common bile duct opens into the intestine. The physician will pass a small tube through the scope and inject a contrast dye through the tube into the bile ducts. This allows for better visualization of the bile ducts on the x-rays. If the exam shows stones in the bile duct the physician may attempt to break them up with a special tool and move them into the intestine. The physician can also enlarge the sphincter of Oddi to allow for the stones to more easily pass into the intestines. During this procedure tissue samples may also be taken for biopsy. The test will take approximately 30 minutes to 2 hours.

You will need to remain at the clinic or hospital for 1-2 hours following the procedure, longer if an intervention was performed during the procedure. You will not be able to eat or drink anything for at least 1 hour following the procedure. After one hour you can advance your diet very slowly. Remember your throat may be sore. Also your gag reflex was paralyzed with the anesthetic and will need time to return in order to prevent choking.

Following the procedure you should contact your healthcare provider should you develop severe abdominal pain, nausea, vomiting, or a fever.

Image above from NIDDK