Diagnostic and Therapeutic ERCP

Understanding Diagnostic and Therapeutic Endoscopic Retrograde Cholangiopancreatography (ERCP)

What is ERCP?
ERCP, is a specialized technique used to study the bile ducts, pancreatic duct and gallbladder. Ducts are drainage routes; the drainage channels from the liver are called bile or biliary ducts. The pancreatic duct is the drainage channel from the pancreas. Typical reasons for performing an ERCP is to remove stones in the bile duct or pancreatic duct and placement of a stent in either duct to bypass a blockage.
How is ERCP performed?
During ERCP, your doctor will pass an endoscope through your mouth, esophagus and stomach into the duodenum (first part of the small intestine). An endoscope is a thin, flexible tube that lets your doctor see inside your bowels. After your doctor sees the common opening to the ducts from the liver and pancreas, called the major duodenal papilla, your
doctor will pass a narrow plastic tube called a catheter through the endoscope and into the ducts. Your doctor will inject a contrast material (dye) into the pancreatic or biliary ducts and will take X-rays.
What can I expect during ERCP?
Ahead of time, your doctor will talk to you regarding the fasting time necessary for the best examination.  Your doctor will also talk to you about your medications and allergies.
Your doctor will  give you a sedative to make you more comfortable. Your doctor might even ask an anesthesiologist to administer sedation if your procedure is complex or lengthy.

Some patients also receive antibiotics before the procedure. You will lie on your abdomen on an X-ray table. The instrument does not interfere with breathing, but you might feel a bloating sensation because of the air introduced through the instrument. Afterwards, if you had the test as an outpatient, you will be observed for complications until most of the effects of the medications have worn off before being sent home.

Potential complications of the procedures include small risk of bleeding, infections, pancreatitis and perforation. Most patients might experience bloating or pass gas because of the air introduced during the examination.

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