The ERCP exam is used for diagnosis and treatment for diseases of the liver, bile ducts, gallblader and pancreas. Specifically the ERCP is most often used for such disorders as Gallstones which are trapped in the main bile duct, lockage of the bile duct, yellow jaundice which turns the skin yellow and urine dark, cancer of the bile ducts or pancreas, pancreatitis, and undiagnosed upped adominal pain.
A flexible endoscope is used to examine the upper gastrointestinal tract. A dye is injected into the bile and pancreatic ducts using a flexible, video endoscope. Then x-rays are taken to outline the bile ducts and pancreas. Video endoscopes have a tiny, optically sensitive computer chip at the end. Electronic signals are then transmitted up the scope to the computer which then displays the image on a large video screen. An open channel in the scope allows other instruments to be passed through it to perform biopsies, inject solutions, or even place stents.
An ERCP uses x-ray films and is performed in an x-ray room. The throat is anesthetized with a spray or solution, and the patient is usually mildly sedated. The endoscope is then gently inserted into the upper esophagus.
What to Expect
The patient breathes easily throughout the exam. A thin tube is inserted through the endoscope to the main bile duct entering the duodenum. Dye is then injected into this bile duct and/or the pancreatic duct and x-ray films are taken. The patient lies on his or her left side and then turns onto the stomach to allow complete visualization of the ducts. If a gallstone is found, steps may be taken to remove it. If the duct has become narrowed, an incision can be made using electrocautery (electrical heat) to relieve the blockage. Additionally, it is possible to widen narrowed ducts and to place small tubing, called stents, in these areas to keep them open. The exam takes from 20 to 40 minutes, after which the patient is taken to the recovery area.
The only preparation needed before an ERCP is to not eat or drink for eight hours prior to the procedure. You may be asked to stop certain medications such as aspirin before the procedure. Check with your physician for more details.
What happens afterwards?
Serious risks during an ERCP exam are rare. You may experience a sore throat for a day or two after the procedure. Due to the mild sedation, the patient should not drive or operate machinery for six hours following the exam. For this reason, a driver should accompany the patient to the exam.