Reasons to Perform ERCP
• Assess cause of jaundice
• Evaluate abnormal liver enzyme levels
• Investigate pain of suspected biliary origin
• Remove stones from the bile duct
• Diagnose tumors of the bile duct or pancreas
• Establish drainage of obstructed bile flow
• Treat sequelae of pancreatitis
• Management of complications from gallbladder surgery

ERCP

 

 

 

Patient Information on ERCP

 

General Overview

ERCP (endoscopic retrograde cholangio-pancreatography) is a procedure which uses a combination of an endoscope and Xray to examine the bile ducts and pancreatic duct. The endoscope is a flexible tube with a small video camera. With the patient under sedation the endoscope is inserted from the mouth to the upper part of the small intestine. Through the endoscope a catheter is advanced into the ducts and Xray pictures are taken. If abnormalities are found, then instruments can be used to take samples for diagnosis or to perform therapies such as stone removal or placement of stents.

Frequently Asked Questions

How is ERCP performed?

An ERCP is performed at the hospital by one of our physicians working with a well-trained team of nurses, technicians, and sometimes other physicians. In many cases it can be done as an outpatient. While lying on an Xray table the patient is given strongly sedating medications by vein. The ERCP scope is inserted into the mouth and gently advanced through the esophagus and just past the stomach into the duodenum, the uppermost part of the small intestine. Tiny instruments are then advanced through the scope and into the ducts where contrast material is injected to enable the ducts to be seen on Xray. In many cases sphincterotomy (an incision of the muscle at the lower end of the duct) or other endoscopic therapies are performed. The procedure takes about an hour on average but can vary from thirty minutes to more than 2 hours.

What is a "SpyGlass" procedure?

In some cases it can be difficult to make a definite diagnosis with standard Xray and tissue sampling techniques. Spyglass is an advanced technology which uses a second tiny "daughter scope." This tiny camera is passed through the standard ERCP scope and then directly into the bile duct. This enables the physician to get a direct view of the inside lining of the duct.

What can I expect after an ERCP?

After the procedure the patient is observed closely in the recovery room while the sedative begins to wear off. Since it takes several hours for full recovery the patient must have a driver to take them home. During the procedure air is inserted into the bowel so the patient may have some bloating, gas, or nausea. Severe pain or fever are not expected and if these occur should prompt notification of our physician. ERCP is an invasive procedure and has about a 10% risk of a complication, similar to many surgical procedures. In some cases the patient is admitted to the hospital after the procedure.