ERCP (Endoscopic Retrograde Cholangio-Pancreatoscopy)

What Is a ERCP?

ERCP is a procedure to diagnose and treat problems of the liver, gallbladder, bile ducts, and pancreas. It combines X-ray and an endoscope – a long, thin flexible tube with a camera at the end. The endoscope passes through the mouth and stomach to where the ducts join the small intestine. A small plastic instrument is then inserted through the endoscope and into the bile and/or pancreatic duct. Often a small cut is made in the opening of the ducts (a sphincterotomy) to allow better drainage. X Rays are then taken and other procedures, such as removing stones, stretching a narrowing or placing a stent can be performed. An ERCP is done in hospital and may require an overnight stay.

When Would One Require an ERCP?

An ERCP is used to treat specific conditions related to the bile duct or pancreatic duct. These include removing stones that might be causing an infection or blocking the duct, taking biopsy samples, and stretching or placing a stent across a narrowing within the duct.

How Do I Prepare For an ERCP?

For the procedure, it is crucial that your stomach be completely empty. You should therefore have nothing to eat or drink for 6 hours prior to your ERCP.

Whilst most medications can be taken as usual with a sip of water on the day of your procedure, some medications should be stopped, or have their dose altered. 

 

Make sure to notify our gastroenterologists at least 7 days prior to your procedure if you are taking:

  • Blood thinners (plavix, warfarin, pradaxa, eliquis, xarelto etc) or
  • Diabetes medications (metformin, gliflozins, insulin etc)

Because x-rays are routinely performed during ERCP, it is critical that you tell your doctor if you could be pregnant, or are allergic to iodine or contrast dye.

Make sure you bring along your referral, a full list of your medications and your Medicare card/Private Health Fund information on the day of your procedure.

What Happens On the Day of the Procedure?

  1. After registering at reception, you will be checked in by a nurse
  2. You will then be seen by your Gastroenterologist and Anaesthetist who will discuss your medical history and explain the procedure.
  3. You will be given a light anaesthetic, and while this is not a general anaesthetic, most patients are very comfortable and do not experience any pain
  4. Once sedated you lying comfortably on your left side, the endoscope is passed gently through the mouth and into your stomach.
  5. The procedure usually takes around 30 minutes 

What Are the Risks or Side Effects?

ERCP is a safe procedure that most patients tolerate extremely well. The most common side effects include mild throat soreness, and abdominal discomfort related to retained air in the stomach. If more serious complications occur, such as pancreatitis, infection, bleeding and perforation, they may require hospitalization.

Pancreatitis is the most frequent serious complication, and usually presents as abdominal pain. Mild cases respond well to intravenous fluids and pain relief, while more serious cases may require intensive care admission and may even result in death.

What Will Happen After my ERCP?

Following the procedure, you will be monitored in the recovery area until most of the sedative medication has worn off. Some patients may need to remain in hospital overnight to be watched for potential side effects. If your procedure is only a day case, it is essential that you have a friend or relative take you home and stay with you for several hours. It is strongly recommended that you do not drive, operate machinery or sign legal documents on the same day after the test.

Please contact GastroX or your nearest hospital if you experience any of the following symptoms after your procedure:

  • Vomiting
  • Worsening abdominal pain
  • Fever
  • Passing blood or black, tarry bowel actions
  • Other symptoms that cause you concern.