ERCP (Endoscopic Retrograde Cholangiopancreatography)
ERCP combines flexible endoscopy with real-time X-ray imaging to diagnose and treat conditions of the bile ducts, gallbladder, and pancreatic duct—areas a standard upper endoscopy cannot reach.
During the procedure, your gastroenterologist can remove gallstones, open narrowed ducts, place stents, or take tissue samples, often resolving the issue in a single session.
Why ERCP Is Performed
ERCP is both diagnostic and therapeutic. It may be recommended to:
- Remove bile-duct stones causing pain, jaundice, or pancreatitis.
- Evaluate recurrent or persistent pancreatitis and relieve duct blockages.
- Investigate unexplained jaundice or abnormal liver tests by visualizing the bile and pancreatic ducts.
- Place stents to keep narrowed ducts open.
- Treat post-surgical complications, such as leaks or obstructions after gallbladder or liver surgery.
Because ERCP carries small but important risks, it is generally performed only when imaging tests—such as ultrasound, MRCP, or CT—show a blockage or condition requiring treatment.
Preparing for Your Procedure
- Fasting: No food or drink for 6–8 hours before your ERCP to ensure an empty stomach.
- Medications: Tell your doctor about blood thinners, diabetes medications, and any allergies (especially to iodine or contrast dye). We’ll let you know if adjustments are needed.
- Medical history: Inform us of any heart, lung, or kidney conditions, or if you’re pregnant.
- Transportation: You’ll receive IV sedation and must arrange a driver, as you cannot drive for 24 hours afterward.
What to Expect
Before the procedure, an IV line will be started, and your vital signs and labs will be reviewed. Sedation is given to keep you relaxed and pain-free, though you may not be fully asleep.
A thin, flexible endoscope is guided through your mouth into the small intestine. Using X-ray guidance, your doctor introduces a small catheter to inject contrast dye into the bile or pancreatic ducts, creating a detailed image. Depending on what’s found, the doctor can cut the duct opening (sphincterotomy), remove stones, dilate narrowed areas, or place stents—all in one session.
The procedure typically lasts 30 to 60 minutes, depending on complexity.
After the Procedure
You’ll recover for about an hour as the sedation wears off. Start with clear liquids, and advance to light foods if instructed. Rest for the remainder of the day, and avoid driving, heavy lifting, or major decisions for 24 hours.
Preliminary results are often discussed before you leave, and biopsy results (if taken) are usually available within a week.
Possible Risks (Uncommon but Important)
While ERCP is safe and effective, potential complications can include:
- Mild pancreatitis (3–10%) — worsening abdominal pain, nausea, or vomiting
- Bleeding after sphincterotomy (<2%) — black or bloody stool
- Infection (cholangitis) (<1%) — fever, chills, or yellowing of the skin or eyes
- Perforation (<0.5%) — severe chest or abdominal pain
- Allergic or sedation reactions — rash or breathing difficulty (rare)
Seek immediate medical attention if you develop severe pain, persistent vomiting, fever, or bleeding after your procedure.
Take Control of Biliary & Pancreatic Health
ERCP offers a minimally invasive alternative to surgery for many complex bile-duct and pancreatic conditions. If imaging suggests a blockage, stone, or stricture—or if you’re experiencing jaundice or pancreatitis—schedule a consultation today.
Your digestive health is our specialty.