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ERCP: Endoscopic Retrograde Cholangiopancreatography

An endoscopic retrograde cholangiopancreatography (ERCP) procedure is used mostly to treat any problems of the pancreas or bile ducts that can cause abdominal pain, usually in the right upper or middle stomach area, and jaundice, yellowing of the skin and eyes.

An ERCP procedure may be used to:

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  • Open the entry of the ducts into the bowel (sphincterotomy).
  • Stretch out narrow segments (bile duct strictures).
  • Remove or crush gallstones.
  • Take tissue samples to diagnose:
    • Tumors of the pancreas, bile ducts or gallbladder.
    • Conditions called biliary cirrhosis, a disease in which the bile ducts in your liver are slowly destroyed or sclerosing cholangitis (inflammation, scarring and destruction of the bile ducts inside and outside of the liver).
  • Drain blocked areas.

How an ERCP Procedure Is Performed

An intravenous (IV) line is placed in your arm. You will lie on your stomach or on your left side for the test.

Medicines to relax or sedate you will be given through the IV.

Sometimes the doctor will use a spray to numb the throat. A mouth guard will be placed in your mouth to protect your teeth. Dentures must be removed.

After the sedative takes effect, the endoscope is inserted through the mouth. The instrument is passed through the esophagus and stomach until it reaches the duodenum, the part of the small intestine closest to the stomach.

You should not feel any discomfort and may have little or no memory of the test.

Once the scope is in place, there will be some stretching of the stomach and duodenum.

A catheter, a thin tube, is passed through the endoscope and inserted into the ducts leading to the pancreas and gallbladder. A special dye is injected into these ducts, and X-rays taken. This helps the doctor see stones, tumors and any areas that have become narrowed.

Special instruments can be placed through the endoscope and into the ducts.

After Completion of an ERCP Procedure

Someone will need to drive you home from the hospital. The air used to inflate the stomach and bowel during an ERCP procedure can cause some bloating or gas for about 24 hours. After the procedure, you may have a sore throat for the first day or up to three to four days.

Do only light activity on the first day after the procedure. Avoid heavy lifting for the first 48 hours. You can treat pain with acetaminophen (Tylenol). Do not take aspirin, ibuprofen or naproxen. Putting a heating pad on your belly may relieve pain and bloating. The doctor or nurse will tell you what to eat. Most often, you’ll want to drink fluids and eat only a light meal on the day after the procedure.