What is an ERCP?
An ERCP (endoscopic retrograde cholangiopancreatography) is a study of the ducts that drain the liver and pancreas. Ducts are drainage routes from organs into the bowel. The ones that drain the liver and gallbladder are called bile or biliary ducts. The one that drains the pancreas is called the pancreatic duct. The bile and pancreatic ducts join together just before they drain into the upper bowel. The drainage opening is called the papilla. It is surrounded by a circular muscle, called the sphincter of Oddi.
What happens during an ERCP?
The ERCP is performed in a room that contains x-ray equipment. You will lie on an special table during the examination, generally on your left side or stomach.
Although many people worry about discomfort from the endoscopy, most people tolerate it well and feel fine afterwards. Medications will be given through the IV line during the procedure. A plastic mouth guard is placed between the teeth to prevent damage to the teeth and endoscope.
The ERCP endoscope is a special flexible tube, approximately the width of a finger. It contains a lens and a light source that allows Dr. Ahmed to view the inside of your pancreas. Images are magnified on a monitor so that even very small details and changes can be seen. The endoscope also contains channels that allow the Dr. Ahmed to take biopsies (painless tissue samples) and introduce or withdraw fluid, air, or other instruments.
Depending on what Dr. Ahmed sees during the ERCP, he may perform a variety of procedures or treatments. These treatments/procedures include, but are not limited to: sphincterotomy, stent placement, balloon dilation or stone removal.
The length of the examination varies, and is generally between 30 minutes and two hours.
What are possible complications related to ERCP?
ERCP is a safe procedure and serious complications are uncommon. If complications do occur, they are usually mild, and may include the following:
- Pancreatitis (inflammation of the pancreas) is the most frequent complication, occurring in about 3 to 5 percent of people undergoing ERCP. When it occurs, it is usually mild, causing abdominal pain and nausea, which resolve after a few days in the hospital.
- The ERCP scope or other instruments can cause a tear or hole in the intestine being examined (called perforation). This is a serious condition, often requiring surgical intervention, although it occurs rarely.
- Infection of the bile ducts (cholangitis) is rare in general, but it can occur, particularly in patients with certain preexisting conditions. Treatment requires antibiotics and drainage of excess fluid.