Endoscopic Retrograde Cholangiopancreatography

An ERCP is a procedure that combines the use of a flexible, lighted scope (endoscope) with x-ray pictures to examine the tubes that drain the liver, gallbladder and pancreas. The endoscope is inserted through the mouth and gently moved down the throat into the esophagus, stomach and duodenum (part of the small intestine) until it reaches the point where the ducts from the pancreas (pancreatic ducts) and gallbladder (bile ducts) drain into the duodenum.

ERCP can treat certain problems identified during the procedure. If an abnormal growth is seen, an instrument can be inserted through the endoscope to obtain a sample of the tissue for further testing (biopsy). If a gallstone is present in the common bile duct, the doctor can sometimes remove the stone with instruments inserted through the endoscope. A narrowed bile duct can be opened by inserting a small wire-mesh or plastic tube (called a stent) through the endoscope and into the duct.

ERCP is used for: (a) gallstones that are trapped in the main bile duct, (b) blockage of the bile duct, (c) jaundice, which turns the skin yellow and the urine dark, (d) cancer of the bile ducts or pancreas, e) pancreatitis (inflammation of the pancreas) and (f) various other pancreato-hepatobiliary conditions that your referring doctor may recommend.

After you schedule your appointment with us, you will be mailed complete instructions on how to prepare for your ERCP procedure. Click here to view a printable ERCP checklist.

Here’s a synopsis of the key things that you should do to prepare:

1. Call your insurance company and ask if the ERCP is covered for the reason given by your doctor.
2. Ask your insurance company if you need a referral for the ERCP. If they say “yes,” then you MUST get a referral from your primary care physician.
3. Make plans for someone to come with you to the hospital.
4. If you take Coumadin®, Plavix® or other blood thinners, please talk to the doctor who prescribed it. In most cases, you cannot have the test while on blood thinners.
5. If you are diabetic, please speak with your doctor about how to take your medication in order to prevent low blood sugar.
6. If you have a contrast allergy, please notify your provider two days prior to the procedure.

You will receive instructions and a slip to the blood draw lab in the mail before your ECRP. Please bring this slip to the blood lab, located in special testing on the first floor, prior to coming to the Gregory Endoscopy Centre.

After you check in, one of our nurses will meet with you to review your medical conditions and medications. An IV line will be placed in a vein in your arm and you may receive an antibiotic before your procedure. You will proceed to the procedure room, where your blood pressure, pulse and oxygen level will be carefully monitored. A sedative also will be administered by an anesthesiologist or nurse anesthetist through your IV, which will put you to sleep.

The back of your throat may be sprayed with a local anesthetic. The endoscope is passed down your throat into your esophagus (the swallowing tube), and through the stomach into your duodenum (part of small intestine). The contrast material (dye) will be used to see your bile ducts and possibly a pancreatic duct. The test itself usually takes less than an hour. After the test, you will rest in the post-anesthesia care unit (PACU) until the effects of the medicine wear off.

You will not be able to drive following the procedure, so plan on having someone with you to take you home. Before leaving, our staff will speak with you about the preliminary results of your test and will let you know when you can go back to eating your regular diet.