Also called Duodenoscopy with Endoscopic Retrograde Cannulation of the Common Bile and Pancreatic Ducts, an ERCP is an examination of the duodenum (first portion of the small intestine) using a thin, flexible scope. Placement of a small tube through the scope and into the duct entrances allows injection of dye, to enhance an x-ray examination of the ducts. This area is thoroughly inspected, and may be photographed. Following is a short explanation of what you might expect before, during and after your visit.
Why has my doctor recommended an ERCP?
ERCP is used primarily to diagnose and treat conditions of the bile ducts, including gallstones, inflammatory strictures, bile leaks and cancer.
Preparation
It is important for the stomach to be empty before an ERCP, so the doctor can completely examine the area. This usually requires having nothing to eat or drink on the day of the test. When scheduling the test, be sure that the doctor knows about any medical problems that you have, any possibility that you might be pregnant, your allergies, and the medications that you take. After you schedule your exam, the doctor's staff will send you information. It is important to follow all instructions completely.
When you arrive at the hospital
Refer to "Planning Your Visit".
Before the procedure
Before the procedure, you will be taken to a private cubicle in the preoperative area, where you will undress and put on a hospital gown. You will be asked several questions about your medical history, the medications that you take, your allergies, and other factors. Please be sure to have a list of your medications with you. An IV line may be inserted into a vein in your arm, to give you fluids and medication during the procedure. You may wait in this area for a short while before your test.
During and after the procedure
After being wheeled to a procedure room and placed on a monitor, your throat may be sprayed with a numbing medication before the exam starts. You will be given sedation to relax you and help to keep you comfortable through the procedure. Staff members will closely watch your condition, measuring your heart, blood pressure, and oxygen levels during and after the test.
For your examination, a lighted instrument will be passed through the esophagus and stomach, then into the duodenum (the portion of the small intestine just below the stomach). If something abnormal is seen or suspected during the procedure, a small portion of tissue may be removed for evaluation under a microscope (biopsy). The lining may be brushed and sent for analysis of abnormal cells (cytology). Small growths (polyps) are often completely removed, using a wire loop and electric current (polypectomy). A narrowed portion of the digestive tract (stricture) may be stretched to a more normal size (dilation). If an area of bleeding is found, the bleeding may be stopped using electric current (cautery). The procedure may also include a papillotomy, a small incision into the papilla (the opening to the common bile duct), through which a catheter or balloon is inserted, to remove any stones from the duct. It may also include placement of a stent (a temporary or permanent plastic tube) into the duct, to keep it open and allow bile to drain more easily. There is always a possibility that complications may occur, but they are rare.
After the procedure, you will be wheeled to the recovery area, to be monitored until you are more fully awake. Your driver may sit with you at this time, and your doctor will speak with you there. You may be given some fluids to drink. Patients usually stay in this area for approximately 1 hour, but may remain longer. After you receive instructions related to your recovery, you will be discharged to the care of your driver. You will not be able to drive a car, operate dangerous machinery, or drink any alcohol for the remainder of the day. Unless you are told otherwise, you should be able to resume most of your normal activities the following day.
