Endoscopic retrograde cholangiopancreatography (ERCP) is used to treat and diagnose problems in the liver, gallbladder, bile ducts, and pancreas. ERCP uses a combination of endoscopy and x-rays. An endoscopy is the use of a special scope with a camera to view your throat, stomach, and upper intestine.
Reasons for Procedure
Your doctor may advise you to have an ERCP if you are suspected of having one of the following:
Blockage of the bile duct
Blockage of the pancreatic duct
A leaky duct
Irritation of the pancreas (pancreatitis) or liver (hepatitis)
Complications are rare, but no procedure is completely free of risk. If you are planning to have an ERCP, your doctor will review a list of possible complications, which may include:
Damage to the esophagus, stomach, small intestine, or bile duct
Pancreatitis (irritation of the pancreas)
Some factors that may increase the risk of complications include:
History of problems with ERCP
Poor overall health
What to Expect
Prior to Procedure
Do not eat for 8-12 hours before the procedure.
If you have diabetes, discuss your medicines with your doctor.
Arrange for transportation after the procedure. (You should not drive for 24 hours after the procedure.)
Inform your doctor if you have had previous allergic reactions to contrast material.
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
Your throat may be sprayed with a medicine to make it numb.
You will be given IV medicine to help you relax.
If your doctor thinks your ERCP will take a long time, you may have
general anesthesia. You will be asleep.
Description of the Procedure
You will lie on your stomach with your head turned to the right. A mouthpiece will be placed in your mouth to help keep it open. An assistant will be in the room to monitor your breathing and heart rate. Your doctor will put an endoscope into your mouth. The scope will be slowly passed through your throat into your esophagus, stomach, and/or small intestine. Air will be passed through the scope to open the airway to see better.
An endoscope allows the doctor to view inside organs.
Your doctor will watch the images on a video monitor. The scope will be passed into the place where the ducts from the liver and pancreas open into the small intestine.
A tiny tube from the endoscope will then be passed into the opening of the bile and pancreatic ducts. Through this tube, your doctor will inject a contrast material. The contrast will make the ducts visible on the x-ray machine. If a gallstone shows up on the images, your doctor may attempt to remove it through the scope. Scarring or narrowing within the ducts can also be treated with instruments passed through the scope. Tissue samples may also be taken through the scope for biopsy. The sample will be sent to a lab for further testing.
Cohen S, Bacon BR, Berlin JA, et al. National Institutes of Health State-of-the-Science Conference Statement: ERCP for diagnosis and therapy, January 14-16, 2002.
Gastrointest Endosc. 2002 Dec;56(6):803-809.
Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 7th ed. Philadelphia, PA: Saunders; 2002.
Textbook of Gastroenterology. 4th ed. Philadelphia, PA: Lippincott, Williams, and Wilkins; 2003.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a