What Is ERCP?

Mary McMahon

Endoscopic retrograde cholangiopancreatography (ERCP) is a medical procedure a doctor may recommend to diagnose problems in the bile ducts associated with the pancreas and liver. It is useful for both diagnosis and treatment, and takes place in a hospital or clinic environment. The test itself can take as long as two hours, and the patient will need to spend some time in the clinic before and after the examination. It may be advisable to take a half or full day off to make time for the procedure.

An endoscope is used in ERCP.
An endoscope is used in ERCP.

In an ERCP, the physician inserts an endoscope through the mouth to access the bile ducts. This provides a series of clear images the doctor can use to evaluate the health of the patient's internal organs. The doctor may spot bile stones, tumors, and other issues that can be removed endoscopically. This allows for very rapid intervention, rather than having to wait for a second procedure to take care of the problem.

At the beginning of an ERCP, an endoscope is passed into the mouth, down past the stomach and into the section of the gut called the duodenum.
At the beginning of an ERCP, an endoscope is passed into the mouth, down past the stomach and into the section of the gut called the duodenum.

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Once the doctor successfully positions the endoscope, the next step is the introduction of contrast material. As the dye flows through the bile ducts, a technician can take a series of X-rays to monitor it as it moves through the body. This can allow the doctor to identify issues like blockages, leaks, inflammation, and other problems that might be causing the patient's condition. Once the ERCP is over, the doctor can send the patient to recovery for monitoring.

ERCP may be recommended to diagnose problems in the bile ducts associated with the pancreas and liver.
ERCP may be recommended to diagnose problems in the bile ducts associated with the pancreas and liver.

Patients may need an ERCP if they experience recurrent abdominal pain, jaundice, and other issues indicative of a problem with the bile ducts. The risks of the basic test are low, although some patients can experience allergic reactions to the contrast material. Patients with known shellfish or iodine allergies should make sure their doctors are aware, as this can affect reactions to contrast dyes. If the doctor removes stones or growths, the risks of the procedure can increase, as the patient may be more prone to inflammation or infection because of the more invasive nature of the procedure.

A pancreas that is not performing correctly may cause bloating and watery stools.
A pancreas that is not performing correctly may cause bloating and watery stools.

Doctors provide medications to keep patients comfortable during an ERCP, which is why they need to wait after the test. A nurse must monitor the patient for signs of bad reactions to the drugs. Once the patient is fully awake and alert with no signs of complications, the doctor can authorize the patient's release. Patients preparing for an ERCP should be aware that they need to take the test on an empty stomach, and may need to adjust medications, an issue they should discuss with their doctors. The doctor can also provide information about timing so patients can plan ahead for rides to and from the procedure, time off work, and other issues.

Endoscopes contain a small camera and light.
Endoscopes contain a small camera and light.

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