ERCP (Endoscopic Retrograde Cholangiopancreatogram) Procedure

What is ERCP?

ERCP is a test that combines the use of a flexible, lighted scope with X-ray pictures to examine the tubes that drain the liver, gallbladder, and pancreas. The long tube is inserted through the mouth and moved through the esophagus, stomach, and duodenum until it gets to where these ducts drain. The X-rays then help the doctor visualize these tiny tubes.

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Preparation for Procedure

  • Continue all medications prior to the exam unless otherwise directed by Dr.Singh
  • If you take any blood-thinners such as Aspirin, Plavix, Coumadin or others, please discuss this with Dr.Singh as he may need to stop these prior to your procedure
  • Inform Dr.Singh if you may be pregnant or have had a prior reaction to Iodine or contrast dye
  • Do not eat or drink anything after midnight
  • The morning of your procedure, you may take all of your usual medications unless otherwise directed by Dr.Singh.
  • You will be sedated during your endoscopy. Because of this you will not be able to drive after the procedure and will need to arrange for someone to drive you home.

During Procedure

Before the procedure you’ll receive an intravenous medication consisting of a sedative and a pain medication to ease your discomfort. ERCP is always performed in a room with X-ray equipment. You will be asked to lie on either your left side or your stomach. A plastic mouth guard will be placed in your mouth. During the procedure a special camera called a duodenoscope will be used. Once you’re sedated, the tube will be passed into the esophagus and stomach. When the endoscope is in place, Dr. Singh will pump some air to open up your esophagus, stomach, and intestine for better viewing and access. Next, he’ll insert a thin tube containing dye through the endoscope and will gently guide it toward the main bile duct. The dye is then injected into the bile duct entering the duodenum, and – if necessary – into the pancreatic duct. Then X-rays are taken. If the X-rays reveal gallstones, they may be removed by Dr. Singh during the same procedure. If a narrowing of the ducts is identified, Dr. Singh may widen the narrowing by placing a stent (a small tube) to keep the duct open. If an abnormal tissue or growth is detected, Dr. Singh will take a tissue sample for a laboratory examination. The length of the ERCP procedure varies: it can take from 30 minutes to 1 ½ hours, depending on its complexity.

After Procedure

Since the sedation used for the procedure can impair your judgment, you’ll need someone to drive you home. You may experience a sore throat, which can be relieved by gargling with salt water. As explained prior to the procedure, a risk of ERCP is pancreatitis. This can occur 5-10% of the time, due to the close proximity of the bile duct to the pancreas. If you have pain, nausea, vomiting, fever, or other symptoms after the procedure, notify Dr. Singh immediately.