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Procedures | Esophagogastroduodenoscopy | Colonoscopy | ERCP
Endoscopic Retrograde Cholangiopancreatography (ERCP): “ERCP” is a specialized technique used to study the ducts of the gallbladder, pancreas, and liver. Ducts are drainage routes; the ducts from the gallbladder and liver are called bile or biliary ducts, while the duct from the pancreas is called the pancreatic duct.
What preparation is required?
The patient should fast after midnight the night before the test. This will ensure that the stomach is empty. Please inform your physician of any allergies to medications including contrast material.
What can I expect during ERCP?
An IV will be placed in your arm so you can receive sedation prior to the procedure. You will be asked to lie on your left side and a local anesthetic will be sprayed in the back of your throat. The physician will then pass an endoscope through your mouth, esophagus, stomach and into the duodenum (the first part of the small intestine). When the common opening to ducts from the liver and pancreas are visualized, a narrow catheter will be passed through the endoscopy and into the ducts. The physician will then inject dye into the ducts and will take x-rays. There may be a bloating sensation due to the air that is introduced through the instrument.
What are possible complications of ERCP?
ERCP is a well-tolerated procedure when performed by gastroenterologists, who have had specialized training in the technique. Although complications requiring hospitalization can occur, they are uncommon. Complications can include pancreatitis (an inflammation or infection of the pancreas), infections, bowel perforation and bleeding. Sometimes the procedure cannot be completed for technical reasons.
Risks vary, depending on why the test is performed, what is found during the procedure, what therapeutic intervention is undertaken, and whether a patient has major medical problems.
What treatments can be done by doing an ERCP?
Sphincterotomy is cutting the muscle that surrounds the opening of the ducts. This cut is made to enlarge the opening. A small wire on the catheter uses electric current to cut the tissue. This does not cause discomfort since there are no nerve endings located there.
Stone removal from the bile duct is the most common treatment. These stones may have formed in the gallbladder and traveled into the bile duct or may form in the duct itself years after your gallbladder has been removed. After a sphincterotomy is performed, stones can be pulled from the duct into the bowel. A variety of balloons and baskets attached to the catheter can be passed through the scope into the ducts allowing stone removal.
Stent placement may be necessary to bypass strictures, or narrowed parts of the duct. These narrowed areas are due to scar tissue or tumors that cause blockage of normal duct drainage.
Balloon dilation is used to stretch the stricture. Dilations with balloons are often performed when the cause of the narrowing is benign. A temporary stent may be placed after dilation to help maintain the dilation.
A tissue biopsy or brushing may be taken to determine if a stricture is due to a cancer.
What can I expect after ERCP?
If ERCP is performed as an outpatient, you will be observed for complications until most of the effects of the medications have worn off. You might experience bloating or pass gas because of the air introduced during the examination. You can resume your usual diet unless instructed otherwise.
Someone must accompany you home from the procedure because of the sedatives used during the exam. Even if you feel alert after the procedure, the sedatives can affect your judgement and reflexes for the rest of the day.
Experience with a gentle touchTM
 Consultants in Gastroenterology
131 Summerplace Dr. / West Columbia, S.C. 29169
803-794-4585
11 Gateway Corners Park / Columbia, SC 29203
803-462-2300
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Procedures | Esophagogastroduodenoscopy | Colonoscopy | ERCP
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