What is an ERCP?
An ERCP is an examination of the drainage system of the liver and pancreas. A flexible tube is inserted through your mouth and passed down the esophagus into your stomach and first part of small intestine. Through this tube, a smaller tube is placed into the drainage system of the bile ducts and pancreas, and a contrast dye is injected. An x-ray machine looks at the
drainage system after the dye is injected. Please let your doctor know if you are allergic to x-ray dye.
Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure done to examine and diagnose problems in the liver, gall bladder, bile, and pancreatic ducts using an endoscope and X-rays. The liver is the largest internal organ that has various functions. One of its functions is the production of liquid called bile which helps with digestion.
The gallbladder is a small, pear-shaped organ that stores the bile until it is used for digestion. The bile ducts are tubes that carry bile from the liver to the gallbladder and small intestine. These ducts are sometimes called biliary trees. The pancreas is a gland that produces enzymes needed for digestion.
ERCP may be used to evaluate the reason for jaundice which could be due to an obstructed bile stone, upper abdominal pain, and unexplained weight loss. The most common indication for ERCP is obstruction or blockage of the ducts either bile duct or pancreatic ducts, most often due to gall stones.
Preparation
You will not be able to eat or drink anything after midnight prior to the procedure. Fasting is recommended for at least 6-8 hours. Talk to your physician regarding your allergies especially to iodine, which is in the dye. You must also arrange for someone to take you home. You will not be allowed to drive, since you were given sedatives during the procedure.
Procedure
For the procedure, you will be placed on your left side on an examining table and the physician will give you medications to numb the back of your throat and a sedative to help you relax during the exam. You will swallow the endoscope, and the physician will then guide the scope through your esophagus, stomach, and duodenum until it reaches the spot where the ducts of the biliary tree and pancreas open into the duodenum. The physician may ask you to lie flat on your stomach, and he will pass a small plastic tube through the scope through which he will inject a dye into the ducts to make them show up clearly on x-rays. A radiographer will begin taking xrays as soon as the dye is injected.
During the exam, if he sees any gallstones or narrowing of the ducts, he will insert instruments into the scope to remove or work around the obstruction. He might also place stents to release the obstruction. During this procedure, he may also be able to take a small sample of the tissue (biopsy) for further testing.
Complications are rare but can occur. Pancreatitis (inflammation of the pancreas), infection, bleeding, and perforation of the duodenum are some possible complications that can be associated with an ERCP.
Results will be discussed with you and your family by your physician after the procedure. The results of the biopsy might take few days and you might need to make an appointment with GIO care for results and procedure follow-up. If you had a stent placed during the procedure your physician will discuss with you when it needs to be removed.
How do i get ready?
One week before the exam:
- Do not take Aspirin, Advil, Ecotrin, Bufferin, Nuprin, Excedrin, Aleve and/or Ibuprofen for 7 days before your exam. Tylenol (acetaminophen), Celebrex, and Mobic are fine to take.
- If you are a diabetic, contact your doctor about adjusting the dose of insulin or blood sugar pills the day of the exam.
Day of the exam:
- Do not have any solid foods or milk products after midnight.
- You may have clear liquids until 4 hours before your exam, then nothing at all until after your exam. Clear liquids (not colored red or purple) include water, soda, broth, bouillon, coffee, tea, Kool-Aid, clear juices, Gatorade, Jello, and popsicles.
- You may take your blood pressure medicine and any heart medicines with a sip of water. Your doctor may give you an antibiotic to take before the procedure with a sip of water.
- Bring a list of current medications and medication allergies with you.
Arrive at the hospital one hour before your appointment to allow for parking and registration in our department.
Transportation
Due to possible lingering effects from the sedation, you cannot drive for the remainder of the day following your procedure, and therefore, you must have a ride home. For your own safety, you will not be discharged unless a responsible adult, over the age of 18, is present to either drive you home or accompany you in a taxi or public transportation.
REGISTRATION:
Enter our waiting room and check-in at the reception desk.
After check-in, you will be called to register.
After registration, you will be called to the procedure area.
Please keep in mind that appointments are approximate times. Delays sometimes occur
What will happen during the examination?
A doctor will explain the benefits and risks of the exam and ask you to sign a consent form giving the doctors permission to do the exam. Ask them any questions you might have.
A nurse will place an IV (needle) in your arm to give you any medicines and fluids you may need during the test. During the examination, medications will be given through your IV to put you to sleep.
Your blood pressure, pulse, and oxygen level will be checked throughout the procedure.
A small breathing tube will be placed in your mouth and down your windpipe. This protects your breathing while you are asleep.
When you are asleep, a flexible endoscope tube will be inserted into your mouth, stomach, and small intestine. This will not interfere with your breathing.
The small tube will be placed through the endoscope to inject dye into the liver and pancreas drainage system.
If your doctor sees anything unusual, a biopsy ( a small piece of tissue) may be taken. You will not feel this.
What happens after the ECRP
You will be taken to our Recovery Room to rest and sleep off the effects of your anesthesia.
Your blood pressure, pulse, and oxygen level will be checked until you are fully awake.
Before you leave, your IV will be removed, you will be given discharge instructions which will note if any tissue was removed.
The doctor will discuss the results of your test with you. The results of your exam and any tissue analysis will be sent to the physician that referred you for the exam in 1-2 weeks.
Please contact the physician who ordered your procedure to obtain your test results. Your throat may feel scratchy or numb for a short while. After you have tested your swallowing with a sip of water, you may have liquids and easy things to swallow for the rest of the day.
After you leave the endoscopic procedure center, if you have a severe pain, shortness of breath, vomiting, increased nausea or fever, You may also go to your local emergency room.
Please call 407-201-3686 for any questions