Endoscopic Retrograde Cholangiopancreatography (ERCP)

Endoscopic retrograde cholangiopancreatography (ERCP) is a way for your doctor to exam the ducts, or small tubes, that empty from the gallbladder and pancreas into first part of the small intestine, called the duodenum. This procedure combines X-ray imaging with endoscopy, which involves your gastroenterologist inserting a flexible tube called an endoscope through your mouth and esophagus and into your stomach and small intestine.

The endoscope includes a light and small camera so your doctor can see inside your digestive system. Medical instruments can also be passed through this tube so your doctor can take tissue samples, or biopsies.

Smaller scopes can be passed through the endoscope and into your pancreatic and bile (gallbladder) ducts so your doctor can see those too. Your doctor may also measure your ducts or look for gallstones and signs of liver disease. Sometimes gallstones can be removed during ERCP.

During your ERCP, your doctor may inject a dye, called contrast, into your ducts so an X-ray can clearly show any places where your ducts are narrow or blocked. Narrow spots can be expanded through ERCP by your doctor placing a small mesh or tube called a stent in the duct to keep it open. Blockages may also be removed during ERCP.

Preparing for your ERCP

It's important that your doctor is able to clearly see your entire upper digestive system, so you'll have to avoid eating and drinking for a number of hours before your ERCP. During the procedure, your doctor may also pump some air into your stomach and small intestine to improve visibility.

Before the procedure begins, you'll be given a sedative that will make you feel drowsy and relaxed, but you'll still be awake. Your doctor may ask you to adjust your position during the exam. A numbing solution may be gargled before the procedure to make it less irritating to swallow the tube.

After your ERCP

After the procedure is over, you may have to wait for a little bit for the sedative to wear off before you go home. Because of the sedative, you should be sure to have someone drive you home after the procedure.