An endoscopic retrograde cholangiopancreatography allows the doctor to diagnose liver, gallbladder, bile duct, and pancreas problems.
An ERCP may be necessary to find the cause of jaundice, upper abdominal pain, or unexplained weight loss. In this test, an X-ray is combined with an endoscope (a long, flexible, lighted tube). Through the endoscope the doctor can see the stomach, duodenum and ducts in the biliary tree and pancreas.
After midnight (or for 6 to 8 hours before) the night before the test, you will not be allowed to eat or drink anything. This insures that the procedure will be accurate. You will need to tell the doctor if you have allergies, particularly if you have an allergy to iodine, which is in the contrast dye. A friend of family member must take you home, you will not be allowed to drive yourself because of the sedative. Follow any other instructions given by the doctor carefully.
You will lie on your left side on an examining table in an X-ray room. You will be given some medication to numb your throat, and a sedative to help you relax. You will swallow the endoscope, and the doctor will navigate it through your esophagus, stomach and duodenum until it gets to the ducts of the biliary tree and pancreas.
You will then be turned to lie flat on your stomach and a small plastic tube will be passed through the scope. Through this tube the doctor will inject dye which will make the ducts show up better on X-rays. A radiologist will then take X-rays. If a gallstone is present, or the ducts are narrowed, the doctor can remove or work around these problems by inserting instruments into the scope. Biopsies may be taken for testing in a laboratory.
An ERCP can take 30 minutes to 2 hours to complete. There may be discomfort when the doctor gently pumps air into the duodenum and injects dye into the ducts. You will need to rest for an hour or two after the procedure until the sedative wears off. You will be checked for complications by the doctor before you are allowed to leave. If any treatments, such as the removal of a gallstone, is done during the procedure, an overnight stay in the hospital may be necessary.
Uncommon complications of the ERCP include pancreatitis (inflammation of the pancreas), infection, bleeding, and performation of the duodenum.
