Endoscopic retrograde cholangiopancreatography (ERCP) is a specialized procedure that combines endoscopy and imaging technology to visualize the bile ducts and, in some instances, to enable therapeutic intervention. An endoscope is a thin, flexible tube attached to a light and a camera.

During an endoscopy, the endoscope is inserted into the mouth of the patient and then moved down the gastrointestinal tract. Surgical instruments are inserted through the endoscope as necessary as the procedure progresses. The main difference between an ERCP and other endoscopies is that an ERCP is specifically used to access the bile ducts, gallbladder, duodenum (the first part of the small intestine), and pancreas. Other types of endoscopies can be used to examine different parts of the digestive tract.

An ERCP is typically performed in an outpatient setting. Because it is done under anesthesia and sedation, the patient should not feel any pain or discomfort while performing the procedure.

Why Perform ERCP?

Endoscopic retrograde cholangiopancreatography, more commonly known as ERCP, is a diagnostic procedure that assists your doctor in determining the possible causes of your symptoms. There is a possibility that you will have this test:

• If your blood tests reveal abnormal liver results.
• If you have severe pancreatic inflammation (pancreatitis), finding out how giant a tumor is can help you decide whether or not you need treatment (the stage).
• If your doctor suspects a blockage in your bile ducts, you may experience symptoms such as yellowing of your skin and the whites of your eyes, itchiness, stomach pain, and dark urine.

As a potential part of your treatment, you might undergo an ERCP. For instance, if there is a blockage in your pancreatic or bile ducts. Your doctor can use the ERCP to insert a plastic or metal tube (known as a stent) into the duct in order to remove the obstruction.

How is ERCP performed?

In most cases, an ERCP is performed as an outpatient procedure, which means that you can return home the same day. The process typically takes between one and two hours to complete. You will be given an anesthetic through an IV (medicine to calm you). You will be awake during the process, but you likely won’t remember any of it afterward.

During an ERCP for diagnostic purposes, your doctor will:

• You will be sprayed with an anesthetic to numb your throat.
• The endoscope will be placed in your mouth, and after being guided through your oesophagus and stomach, it will be inserted into the top portion of your small intestine.
• The endoscope pumps air into the stomach and duodenum, making it much simpler to observe the organs inside.
• To access the bile and pancreatic ducts, a separate tube, known as a catheter, is slid into the endoscope until it reaches its target.
• A specialized dye is injected into the patient through the catheter.
• The fluoroscopy procedure involves taking video X-rays of the digestive tract as the dye is passed through the ducts.
• Examines the system for any indications of obstruction or problems.

For treatment, your doctor may put tiny devices through the endoscope to check if:

• Stones should be broken up and taken out.
• In order to unblock ducts that have been obstructed or narrowed, stents may be inserted.
• Take tissue samples or remove tumors before performing a biopsy.

Prepare for ERCP?

• Before the procedure, don’t eat, drink, or smoke for at least six hours. Clear liquids like water may be OK.
• Tell your doctor if you have any allergies, especially if you have previously had problems with intravenous (IV) contrast dyes. If you have had an allergic reaction, you may need to take allergy medicine before the procedure.
• Give your doctor’s office a list of all the medicines and supplements you are taking.
• Talk to your doctor about whether you should stop taking medications like aspirin and warfarin that thin the blood.
• If you think you might be pregnant, tell your doctor. Some kinds of anesthesia can hurt a baby still in the womb.