Endoscopic Retrograde Cholangiopancreatography (ERCP)

Endoscopic retrograde cholangiopancreatography (ERCP) is a specialized medical procedure that examines the bile and pancreatic ducts using an endoscope to diagnose and treat various conditions.

Bile ducts transport bile from the liver to the gallbladder and small intestine. In contrast, pancreatic ducts carry fluids from the pancreas into the small intestine.

ERCP is primarily used to diagnose problems that cause abdominal pain, jaundice (yellowing of the skin and eyes) and other related symptoms. Conditions that are normally evaluated and treated with this procedure are bile duct stones, pancreatic duct stones, tumors, strictures, primary biliary cholangitis and sclerosing cholangitis and bile leaks.

ERCP Procedure Overview

Sedation: Medications to help you relax or sedate you will be administered through an IV. Sometimes, a numbing medication is used for the throat. A bite block is placed to protect your teeth and you may be asked to remove your dentures.

Endoscope Insertion: Once the sedative takes effect, the doctor will insert the endoscope through your mouth, guiding it through the esophagus and stomach to reach the first part of your small intestine (duodenum). You will likely lie on your stomach or left side during the procedure.

Dye Injection and X-rays: A thin tube (catheter) is passed through the endoscope into the bile and pancreatic ducts. A special dye is injected, and X-rays are taken to help the doctor visualize stones, tumors, or narrowed areas.

Treatment: Special instruments can be inserted through the endoscope to treat identified issues within the ducts, such as removing gallstones, placing stents, or taking tissue samples for biopsy.

After the Procedure

• Recovery: Someone needs to drive you home. You may feel bloated and have a sore throat for a day or two.
• Activity: Avoid heavy lifting and strenuous activities for 48 hours. Rest and do light tasks.
• Pain Relief: Use acetaminophen for pain. Don’t take aspirin, ibuprofen, or naproxen. A heating pad can help with bloating.
• Diet: Follow your doctor’s diet advice. Start with fluids and light meals.

Possible Complications

ERCP is generally safe, but like any medical procedure, there are some risks. Potential complications include:

• Infection
• Bleeding
• Pancreatitis (inflammation of the pancreas)
• Perforation (a tear in the gastrointestinal tract)
• Allergic reaction to sedatives or contrast dye

When to Call Your Doctor

After the procedure, contact your doctor if you experience:

• Severe abdominal pain or persistent bloating
• Rectal bleeding or black stools
• Fever above 100°F (37.8°C)
• Nausea or vomiting

General Preparation Instructions for Gastrointestinal Procedures

Each gastrointestinal procedure requires specific preparations to ensure your safety and the success of the treatment. Here are some general guidelines:

• Fasting: Avoid food and drinks, including water, for several hours, or more as instructed by your healthcare provider.
• Medications: You may need to adjust or pause certain medications. Follow the specific directions given by your doctor.
• Bowel Prep: Some procedures require clearing the intestines using either a liquid solution or pills containing laxatives. Procedures like colonoscopy, flexible sigmoidoscopy, and PillCam capsule endoscopy typically require this type of preparation.

Please consult your doctor for detailed preparation instructions tailored to your health needs and the specific procedure.

Schedule an Appointment

Scheduling your appointment is through your gastroenterologist or by physician referral to one of our gastroenterologists.

Please contact your Gastroenterologist's office to schedule an exam/appointment. Contact us at 909.865.9141 for inquiries or questions.

If you do not have a primary care physician, please visit our website, mypvhc.com, to schedule an appointment with a primary care physician.