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ERCP Endoscopic Retrograde Cholangio-Pancreatography

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ERCP Endoscopic Retrograde Cholangio-Pancreatography This information was developed by the Publications Committee of the American Society for Gastrointestinal Endoscopy (ASGE). For more information about ASGE, visit www.asge.org. ERCP Endoscopic retrograde cholangio-pancreatography Endoscopic retrograde cholangio- pancreatography, or ERCP, is a DUODENUM GALL specialized technique used to BLADDER study the ducts of the gall- BILE bladder, pancreas and liver. DUCT Ducts are drainage routes; the drainage channels from the liver are called bile or biliary ducts. The pancreatic duct is the drain- age route from the pancreas. PANCREAS about how to prepare. You should talk PANCREATIC DUCT to your doctor about medications you take regularly and any allergies you have to medications or to intravenous contrast material (dye). Although an MAJOR DUODENAL allergy doesn’t prevent you from hav- PAPILLA ing ERCP, it’s important to discuss it with your doctor prior to the proce- What is ERCP? common opening to the ducts from the dure, as you may require specific al- liver and pancreas, called the major Endoscopic retrograde cholangio-pan- lergy medications before the ERCP. duodenal papilla, your doctor will pass creatography, or ERCP, is a specialized Inform your doctor about medica- a narrow plastic tube called a catheter technique used to study the bile ducts, tions you’re taking, particularly as- through the endoscope and into the pancreatic duct and gallbladder. Ducts pirin products, arthritis medications, ducts. Your doctor will inject a contrast are drainage routes; the drainage chan- anticoagulants (blood thinners, such material (dye) into the pancreatic or nels from the liver are called bile or as warfarin or heparin), clopidogrel biliary ducts and will take X-rays. biliary ducts. The pancreatic duct is the or insulin. Also, be sure to tell your drainage channel from the pancreas. doctor if you have heart or lung con- What preparation is required? ditions or other major diseases which How is ERCP performed? You should fast for at least six hours might prevent or impact the decision (and preferably overnight) before the to conduct endoscopy. During ERCP, your doctor will pass procedure to make sure an endoscope through your mouth, you have an empty stom- esophagusPOLYP and stomach into the duo- ach, which is necessary denum (first part of the small intes- for the best examination. tine). An endoscope is a thin, flexible YourPOLYP doctor will give tube that lets your doctor see inside you precise instructions your bowels. After your doctor sees the An endoscope is a thin, flexible tube that lets your doctor see inside your digestive tract. During ERCP, your doctor will pass an endoscope through your mouth, esophagus and stomach into the first part of the small intestine. 1 f.y.i. What can I expect during ERCP? What are possible Because individual circum- complications of ERCP? Your doctor might apply a local anes- stances may vary, this brochure thetic to your throat and/or give you a ERCP is a well-tolerated procedure may not answer all of your when performed by doctors who are questions. Please ask your sedative to make you more comfort- doctor about anything you able. Your doctor might even ask an an- specially trained and experienced in the don’t understand. esthesiologist to administer sedation if technique. Although complications re- your procedure is complex or lengthy. quiring hospitalization can occur, they Some patients also receive antibiot- are uncommon. Complications can in- What can I expect after ERCP? clude pancreatitis (inflammation of the ics before the procedure. You will lie If you have ERCP as an outpatient, you pancreas), infections, bowel perforation on your abdomen on an X-ray table. will be observed for complications until and bleeding. Some patients can have The instrument does not interfere with most of the effects of the medications an adverse reaction to the sedative used. breathing, but you might feel a bloating have worn off before being sent home. Sometimes the procedure cannot be sensation because of the air introduced You might experience bloating or pass completed for technical reasons. Risks through the instrument. gas because of the air introduced dur- vary, depending on why the test is per- ing the examination. You can resume formed, what is found during the pro- your usual diet unless you are instruct- cedure, what therapeutic intervention ed otherwise. Someone must accom- is undertaken and whether a patient pany you home from the procedure be- has major medical problems. Patients cause of the sedatives used during the undergoing therapeutic ERCP, such as examination. Even if you feel alert after for stone removal, face a higher risk of the procedure, the sedatives can affect asge.org complications than patients undergo- your judgment and reflexes for the rest screen4coloncancer.org ing diagnostic ERCP. Your doctor will of the day. discuss your likelihood of complications with you before you undergo the test. If the pancreatic ERCP is sometimes used duct is found to to make a diagnosis of be disrupted, ERCP chronic pancreatitis. may be recom- mended to correct the abnormality. A large bile duct stone is impacted at the major duodenal papilla causing obstruction and severe ERCP is the most appropriate procedure infection of the bile duct. In this to remove stones from the bile duct. case, ERCP is urgently required to On this X-ray, there are multiple stones relieve the obstruction. lodged in the bile duct. 2 Notes or questions: This information is intended only to provide general guidance. It does not provide definitive medical advice. It is important that you consult your doc- tor about your specific condition. Since its founding in 1941, the American Society for Gastrointestinal Endoscopy (ASGE) has been dedicated to advancing patient care and diges- tive health by promoting excellence in gastrointestinal endoscopy. ASGE, with more than 11,000 members worldwide, promotes the highest standards for endoscopic training and practice, fosters endoscopic research, and is the foremost resource for en- doscopic education. This information is the opinion of and provided by the American Society for Gastrointestinal Endoscopy. Copyright © 2010. American Society for Gastrointestinal Endoscopy. All rights reserved. This information may not be reproduced without express written permission by ASGE. For permission requests, please contact the ASGE Communications Department at 630-673-0600. PEB18 3.
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