ERCP (endoscopic retrograde cholangiopancreatography) is an advanced endoscopic procedure, which is used to treat disorders of the bile duct and pancreas. It involves feeding a fine plastic tube down through a specialised endoscope into the bile duct (and less often the pancreatic duct) to deal with conditions like gallstones and blockages of the bile duct.
Common reasons for patients requiring an ERCP include:
gallstones which have escaped from the gall bladder, causing blockage of the bile duct (jaundice, abnormal liver function tests and infection of the bile tree, “cholangitis”) or pancreas duct (resulting in pancreatitis).
tumours of the pancreas or bile duct, causing jaundice and itch.
ERCP is usually performed to treat these conditions:
gallstones in the bile duct can be removed after enlarging the opening into the duodenum.
stents can be inserted across blockages to allow flow of bile to the duodenum to resume.
Stomach must be completely empty before having a ERCP and this achieved by no food for 6 hours and no liquids for 3 hours prior to the procedure.
The procedure itself generally takes no more than an hour with the patient under deep sedation. The observation period afterwards is a minimum of 4 hours and patients can leave after this when given the OK by medical staff. Do not drive or operate any machinery until the following day.
ERCP is a riskier procedure than endoscopy or colonoscopy. The risks include:
technical failure.
post-procedure pancreatitis (inflammation of the pancreas).
bleeding (uncommon)
perforation of the duodenum (very uncommon).
Dr Bell will discuss the risks associated with ERCP, based on your own personal circumstances.