(ERCP) enables the physician to diagnose
problems in the liver, gallbladder, bile
ducts, and pancreas. The liver is a large
organ that, among other things, makes a
liquid called bile that helps with
digestion. The gallbladder is a small,
pear-shaped organ that stores bile until it
is needed for digestion. The bile ducts are
tubes that carry bile from the liver to the
gallbladder and small intestine. These ducts
are sometimes called the biliary tree. The
pancreas is a large gland that produces
chemicals that help with digestion.
ERCP may be used to discover the reason for jaundice, upper abdominal pain, and unexplained weight loss. ERCP combines the use of x-rays and an endoscope, which is a long, flexible, lighted tube. Through it, the physician can see the inside of the stomach, duodenum, and ducts in the biliary tree and pancreas.
For the procedure, you will lie on your abdomen on an examining table in an x-ray room. You will be given medication to help numb the back of your throat and a sedative to help you relax during the exam. You will swallow the endoscope, and the physician will then guide the scope through your esophagus, stomach, and duodenum until it reaches the spot where the ducts of the biliary tree and pancreas open into the duodenum. At this time, physician will pass a small plastic tube through the scope. Through the tube, the physician will inject a dye into the ducts to make them show up clearly on x-rays. A radiographer will begin taking x-rays as soon as the dye is injected.
If the exam shows a gallstone or narrowing of the ducts, the physician can insert instruments into the scope to remove or work around the obstruction. Also, tissue samples (biopsy) can be taken for further testing.
Possible complications of ERCP include pancreatitis (inflammation of the pancreas), infection, bleeding, and perforation of the duodenum. However, such problems are uncommon. You may have tenderness or a lump where the sedative was injected, but that should go away in a few days or weeks.
ERCP takes 30 minutes to 2 hours. You will be sedated during the procedure and should not have any discomfort. After the procedure, you will need to stay at the hospital for 1 to 2 hours until the sedative wears off. The physician will make sure you do not have signs of complications before you leave. If any kind of treatment is done during ERCP, such as removing a gallstone, you may need to stay in the hospital overnight..
PreparationYour stomach and duodenum must be empty for the procedure to be accurate and safe. You will not be able to eat or drink anything after midnight the night before the procedure, or for 6 to 8 hours beforehand, depending on the time of your procedure. Also, the physician will need to know whether you have any allergies, especially to iodine, which is in the dye. You must also arrange for someone to take you home--you will not be allowed to drive because of the sedatives. The physician may give you other special instructions.
Please contact us for additional questions regarding ERCP.