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What is Endoscopic retrograde cholangiopancreatography (ERCP)?

Endoscopic retrograde cholangiopancreatography, or ERCP, is an invaluable minimally invasive procedure used to diagnosis and treat disorders of gallbladder, liver, bile duct and pancreas that cause symptoms. The procedure is primary used to diagnose or treat problems that cause abdominal pain, usually on the right upper or middle stomach, and yellowing of the skin and eyes (jaundice).

It is an outpatient procedure performed under conscious sedation, IV medication to help you relax and block pain. This is a safe and effective way to keep you comfortable during your procedure and allows you to recovery quickly.

Importantly, ERCP is an advanced therapeutic technique that must be performed by the highly trained and experienced gastroenterologists at Gastroenterology Associates of Brooklyn.

The procedure is most commonly used to

  • remove gallstones
  • reduce strictures (narrowing of the bile ducts) which may include draining and stenting of the ducts to remove obstructions
  • open the entry of bile ducts into the colon
  • diagnose tumors, pancreatitis, and other conditions
  • take biopsies of the pancreas, bile ducts or gallbladder
  • drain blockages

You will be instructed on how to prepare for this procedure. Generally, you should stop eating 6 hours before the test and stop taking aspirin and receive instructions on discontinuing blood thinners and specific medications before the test. You will sign a consent form.

An intravenous IV line will be placed in your arm. This is how you will receive the medication to relax and sedate you. You will lie on your side and the sedation medication will begin to work. Your Gastroenterology Associates of Brooklyn GI doctor will spray a topical anesthetic in your throat to numb you, so you won’t feel the endoscope going down the esophagus. They will also place a mouth guard in your mouth to protect your teeth.

Once you are sedated, a small endoscope, a flexible tube with a light and camera, is inserted through the mouth into the stomach and duodenum (the first part of the small intestine). Small amounts of contrast dye are injected into the ducts that lead to the pancreas and gallbladder, and show up on X-ray images, allowing your doctor to get a better view.

When an abnormality is diagnosed, ERCP can be used to treat it with tools inserted through the endoscope. This could include capturing gallstones with a basket, cutting or stretching narrowed ducts and injecting medications into the pancreas.

ERCP is an effective way to diagnose and treat problems in the bile ducts and pancreas. It often provides quicker results than other methods of imaging and its minimally invasive nature makes it a popular choice for many patients. It is important to discuss the risks and benefits of ERCP with your doctor before undergoing the procedure.

After your procedure, you will go to recovery and when you are alert and ready, you will be discharged, usually 1-2 hours after the procedure. You will not be permitted to drive and will need someone to pick you up.  You may have a sore throat for a few days. You will receive going home instructions for recovery at home.

Just like any medical procedure, there are certain risks associated with ERCP. These include allergic reaction to contrast dye, bleeding in the stomach or duodenum, infection, and injury to the bile ducts or pancreas. Additionally, ERCP is not always successful in diagnosing or treating a problem. It may need to be repeated if it doesn’t provide enough information.

Overall, ERCP can help provide important diagnostic and treatment information that can improve outcomes for patients. Though it does involve some risks, these can often be minimized or avoided with proper preparation and care. Talk to your Gastroenterology Associates of Brooklyn GI doctor about the risks and benefits of ERCP before undergoing the procedure. They will explain the procedure and answer your questions.