An endoscopic retrograde cholangiopancreatography procedure, or an ERCP, is a procedure used to identify gallstones, tumors or narrowing in your bile ducts. This procedure is done using an endoscope, which is a thin, flexible tube with a light attached. The endoscope is inserted into your body through your mouth so your doctor can see inside.
ERCP is a highly specialized procedure that should only be performed by experienced, skilled doctors. At MedStar Georgetown, our renowned endoscopic specialists perform a high volume of ERCPs yearly with an excellent success rate.
Why perform an ERCP?
If you are having abdominal pain, especially if it is in the right upper or middle stomach area and accompanied with jaundice (yellowing of the skin and the whites of the eyes), your doctor may want to do an ERCP to identify any problem with the pancreas or bile ducts.
Bile is a digestive fluid that is made and released by the liver and stored in the gallbladder. It helps break down fats into fatty acids so the body can digest them. The bile duct is the tunnel through which the bile passes.
Sometimes, an endoscopic sphincterotomy (ES) is done at the same time as an ERCP. During a sphincterotomy, your doctor cuts the sphincter muscle of the bile or pancreatic duct to remove gallstones.
What can I expect from an ERCP procedure?
Before the procedure:
- You may not eat or drink after midnight.
- Remove any jewelry so it does not interfere with the X-ray.
- Sign a consent form.
During the procedure:
- An IV line is placed in your arm through which you receive medicines and sedatives.
- Your throat may be sprayed to numb it and a mouth guard will be placed to protect your teeth. If you wear dentures, you will need to remove them.
- Once the sedative takes effect, the doctor inserts the endoscope into your mouth where it passes through your esophagus (food passage tub), into your stomach and to the duodenum (first part of the small intestine, closest to the stomach).
- The doctor passes a catheter (a thin tube) through the endoscope and inserts it into the ducts that lead into the pancreas and gallbladder.
- A dye is injected into the ducts to highlight any abnormalities, and X-rays are taken. This allows your doctor to see any stones, tumors or narrowing of the ducts.
Your doctor may insert specialized instruments through the endoscope to:
- Open the entry of the ducts into the bowel
- Stretch out narrow segments
- Remove or crush gallstones
- Take a tissue sample for analysis (biopsy)
- Drain blocked areas
This procedure can be both diagnostic and a form of treatment, depending on your condition.
What is recovery like after an ERCP?
During the procedure, air is used to inflate your stomach and bowel so your doctor has better visualization of the operating field. The air may cause some bloating or gas. You may have a sore throat for a few days due to the insertion of the tubes.
On occasion, patients have a bad reaction to the dye or the drugs used to relax the duodenum.
These reactions include:
- A burning sensation
- Blurred vision
- Urine retention