What is a ERCP (Endoscopic retrograde cholangiopancreatography)?

Endoscopic retrograde cholangiopancreatography or ERCP is a procedure used to diagnose and treat problems with the liver, gallbladder, bile ducts, and pancreas. It combines X-ray imaging with the use of an endoscope, which is a long, flexible, and lighted tube. It may also be done to diagnose.

  • Pancreatitis or cancer in the liver or bile ducts.
  • Bile duct obstructions or stones.
  • Leakage of fluid from the bile or pancreatic ducts
  • Pancreatic duct blockages
  • Tumours
  • Inflammation of the bile ducts

When is ERCP (Endoscopic retrograde cholangiopancreatography) required?

You may require an ercp procedure to determine the cause of unexplained abdominal pain or skin and eye yellowing (jaundice). If you have pancreatitis or cancer of the liver, pancreas, or bile ducts, it may be used to obtain more information.

Why is ERCP (Endoscopic retrograde cholangiopancreatography) done?

ERCP is used by doctors to diagnose and treat problems in the pancreatic and bile ducts. For example, if your doctor suspects pancreas or liver disease, or a problem with the bile ducts, you may undergo ERCP. You may also have ERCP to determine the cause of abnormal results from a blood test, ultrasound, or CT scan, or to correct a problem discovered during one of these tests. Finally, ERCP can assist your doctor in determining whether you require surgery and, if so, which surgery is best for you.

How is ERCP (Endoscopic retrograde cholangiopancreatography) done?

ERCP is typically performed as an outpatient procedure, which means the patient can go home the same day. The procedure can take between one and two hours. IV anesthesia will be given first. The patient will stay awake during the procedure, but won't remember much of it. After that, the patient can leave for home.

ERCP (Endoscopic retrograde cholangiopancreatography) Procedure

Before the procedure

The doctor will suggest you on before surgery instructions. General instructions are -

  • Eat, drink, for at least six hours prior to the procedure. Clear liquids, such as water, may be acceptable.
  • Do not smoke before the procedure.
  • Notify your doctor if you have any allergies, especially if you have had previous allergic reactions to intravenous dyes. If you've previously experienced an allergic reaction, you may need to take allergy medications prior to the procedure.
  • Inform your doctor about all of your medications and supplements.
  • Consult your doctor about discontinuing blood-thinning medications such as aspirin and warfarin.
  • Inform your doctor if you are pregnant. Certain types of anesthesia can be harmful to an unborn child.

During the procedure

  • An anesthetic spray will be given to numb the throat.
  • Insert the endoscope into the mouth and guide it through your esophagus and stomach to the upper portion of the small intestine.
  • Pump air through the endoscope into the stomach and duodenum to make organs more visible.
  • Insert a catheter, which is a different tube, into the endoscope until it reaches the bile and pancreatic ducts.

After the procedure

There might be irritation in the throat after the endoscopic procedure. The doctor will advise eating soft foods for a day or two until the pain goes away.

Following an ERCP, you may experience bloating (a swollen sensation caused by the pumped-in air) and nausea (an anesthesia side effect). With your doctor's approval, you should be able to return to work and normal activities the next day.

Potential risks and complications of ERCP

Some patients are allergic to the IV dye used during the X-ray portion of the procedure. If this occurs, your doctor will administer medication to stop the reaction as soon as possible. Other uncommon but possible complications include:

  • Infection of the gallbladder or bile duct.
  • Cut or incision in the stomach, ducts, or small intestine.
  • Pancreas inflammation and swelling (pancreatitis).
  • Internal bruising.

When to consult a doctor?

After this procedure if you have any of the following symptoms, contact your doctor:

  • Breathing difficulties or chest pain
  • Fever or other infection-related symptoms
  • Severe abdominal pain that is worsening or a sore throat.
  • Rectal bleeding symptoms include dark, tarry stool.
  • Vomiting.

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Frequently Asked Questions

1. Are endoscopy and ERCP the same?

Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure that combines upper GI endoscopy and x-rays to treat bile and pancreatic duct problems.

2. Is ERCP effective in removing gallstones?

The ERCP procedure can remove gallstones from the bile duct but not from the gallbladder.

3. Is an ERCP a painful procedure?

No, ERCP is not painful because it is performed under anesthesia sedation.

4. Does ERCP cause any side effects?

ERCP might cause some side effects such as -

  • Severe abdominal pain.
  • Fever or chills.
  • Vomiting blood.
  • Difficulty swallowing or breathing.
  • Sore throat.
  • 5. When should a stent be removed after ERCP?

    To reduce the risk of stent obstruction, plastic biliary ercp procedure stents are commonly placed during endoscopic retrograde cholangiopancreatography (ERCP) and should be removed or replaced within 3 months.

    6. Will I be awake during ERCP procedure?

    You will be under IV anesthesia and won’t be awake.

    7. What is the ercp test cost in India?

    The cost range of the ercp test might be between 10,000 to 50,000. However, it might depend on various factors such as severity, age, place, etc.

    8. Does ERCP require hospitalization?

    No, it can be performed on an outpatient or daycare basis.