Endoscopic Retrograde Cholangiopancreatography (ERCP)

What is ERCP?

ERCP is a highly specialised endoscopic procedure, where x-ray images are taken of the bile ducts (tubes draining bile fluid from the liver) or pancreatic ducts (tubes draining the pancreas digestive enzymes) into the duodenum - the first part of the small intestine.

Why is ERCP performed?

ERCP is performed to diagnose and treat conditions involving the bile ducts or pancreatic ducts.  These conditions include stones, jaundice (yellow discolouration of the eyes and skin) or tumours of the bile ducts or pancreas.  Often, abnormalities are initially identified by your doctor on blood tests or scans such as an ultrasound, CT scan or MRI.  In addition, complications following gallbladder surgery can sometimes be diagnosed and treated with ERCP.

What can I expect during the ERCP?

You will have sedation medications administered by our specialist anaesthetists to make you more comfortable.  A local anaesthetic spray may also be applied to numb your throat.  Often, anti-inflammatory medication is administered rectally once you are sedated.  This can decrease the risk of pancreatitis (see below). Often, antibiotics will also need to be administered.  The procedure can last up to an hour depending upon what condition is being treated, and then you are placed on a special fluid diet for a few hours afterwards.

How do I prepare for ERCP?

Patients are required to fast for 6 hours before an ERCP so that the stomach is empty.  Some of your medications may need to be omitted or the dose adjusted – we will advise on any changes required at the time of consultation. If you have any allergies to contrast dyes or other medications, you will need to inform us.

Will I need to stay overnight in hospital

Patients often require observation for up to 24 hours following an ERCP, so we advise that you bring an overnight bag with change of clothes and toiletries.  This is to confirm results of the procedure, and to observe for any complications that may occur.

What are the risks of ERCP?

ERCP is a very safe procedure, and only doctors with dedicated specialised training and accreditation can perform ERCP. However, complications can still occur.  The most common complication is inflammation of the pancreas, called pancreatitis, which can result in abdominal pain, nausea and vomiting.  This may occur in up to 5% of patients (1 in 20). Other uncommon complications include infection and bleeding, and very rarely, a tear in the lining of the gut called a perforation.

What is the follow up after my ERCP?

We may ask that you return to see our doctors to discuss results of any tissue samples (biopsies) taken, or to monitor your blood test results.  You will be advised of this prior to discharge from the hospital.  Occasionally a plastic or metallic tube (stent) may need to be placed into the bile or pancreatic duct and we will advise you when this will need to be removed.

Further Information

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