ERCP (Endoscopic Retrograde Cholangio-Pancreatography)…

ERCP stands for:

  • Endoscopic — It Refers to a tool called an endoscope, a long, thin generally about the width of your little finger, flexible tube with a camera and light on the end. 
  • Retrograde — It refers to the direction mostly backward, in which the endoscope injects a liquid for X-rays of parts of the GI tract called the bile duct system and pancreas.
  • Cholangio — It Refers to the bile duct system.
  • Pancreatography — It Refers to the pancreas.
  • The process of taking these X-rays is known as cholangiopancreatography. 

What Is ERCP??

ERCP is a medical procedure that enables the physician to examine the pancreatic and bile ducts inside the body. A bendable, lighted tube (endoscope) most likely about the thickness of your index finger is placed through your mouth and into your stomach and the first part of the small intestine (duodenum). In the duodenum, a small opening is identified (ampulla) and a small plastic tube (cannula) is passed through the endoscope and into this opening. Dye (contrast material) is injected and X-rays are taken to study the ducts of the pancreas and liver.

Or we can also say ERCP, is an endoscopic technique that is used to examine and treat problems related to the bile and pancreatic ducts, and the gallbladder. The bile ducts are channels, analogous to plumbing, that drain bile from the liver and gallbladder; the pancreatic ducts drain the pancreas. Both types of ducts empty into the duodenum, which is the first part of the small intestine.

Why Test Is Performed??

There are 3 major reasons why ERCP test is performed and those are:-

  • ERCP is mostly performed to diagnose conditions of the pancreas or bile ducts and is also used to treat those conditions. It is used to evaluate symptoms of disease in these organs or to further clarify abnormal results from blood tests or imaging tests such as ultrasound or CT scan. The most common reasons to do ERCP include abdominal pain, weight loss, jaundice (yellowing of the skin), or an ultrasound or CT scan that shows stones or a mass in these organs.
  • Another use of ERCP is before or after gallbladder surgery to assist in the performance of that operation. Bile duct stones can be diagnosed and removed through ERCP. Tumors, both cancerous and noncancerous, can be diagnosed and then treated with indwelling plastic tubes that are used to bypass a blockage of the bile duct. Complications from gallbladder surgery can also sometimes be diagnosed and treated with ERCP.
  • In patients with suspected or known for some kind of pancreatic disease, ERCP will help determine the need for surgery or the best type of surgical procedure to be performed. Occasionally, pancreatic stones can be removed by ERCP.
  • Often, in many of these situations, an ultrasound of the abdomen or a special kind of MRI study called MRCP may be performed to obtain preliminary information that acts as a guide the need for ERCP.

How ERCP is Performed??

ERCP is performed by gastroenterologists or surgeons who have specially trained for this technique. An endoscope is a long and flexible tube with a camera and a light at the tip of it. First, you will be adequately sedated to the point of appearing asleep (often referred to as “conscious sedation” or “moderate sedation”). Usually, this is achieved with intravenous medications, but sometimes general anesthesia is necessary.

The endoscope or tube piece is placed into the mouth and then pulled into the esophagus, stomach, and to the point in the duodenum where the bile duct enters; this is known as the papilla. A plastic catheter a type of thin tube is threaded through the scope to come out its tip and then is maneuvered to enter the papilla and the ducts. Contrast dye which is a radio-opaque material is then injected into the ducts and x-rays are taken. By examining the ducts in this way, information about blockages, stones, tumors, or irregularities of the ducts can be gathered. If abnormalities are found, the doctor can perform techniques to repair or improve the condition.

For example, if stones are seen, the papilla can be widened or cut open and stones may be removed from the duct. The papilla contains a sphincter muscle that is often cut using cautery which is the passage of electric current during the procedure of sphincterotomy, which allows for better duct drainage.

What Type Of Preparations Should Be Done For ERCP?

You will be required to fast prior to this procedure i.e. stomach must be empty, so you should not eat or drink anything for approximately 8 hours before the examination. Your physician will be more specific about the time to begin fasting depending on the time of day that your test is scheduled. The stomach should be empty in order for the stomach to be fully visualized. An empty stomach also reduces the risk of vomiting and aspiration.

The patient should discuss all current medications you are going through at present with the doctor, as some may need to temporarily stop prior to the procedure. This step is especially important if you are taking aspirin, blood thinners (warfarin or heparin), clopidogrel, nonsteroidal anti-inflammatory drugs, insulin, or other medicines for diabetes. Blood-thinning medicines and aspirin or clopidogrel may need to be discontinued several days prior to your procedure. It is also important to discuss any medication allergies, including those to iodine or intravenous (IV) contrast dye.

What Are The After Symptoms Of ERCP??

After ERCP, the patient can expect the following things:

  • You will most often stay at the hospital or outpatient center for 1 to 2 hours after the procedure just because sedation or anesthesia can lose its effect on the body. In some cases, you may need to stay overnight in the hospital after ERCP.
  • The patient can have bloating or nausea for a short time after the procedure.
  • The Patient can have a sore throat for 1 to 2 days.
  • You can go back to a normal diet once your swallowing has returned to normal.
  • You should rest at home for the remainder of the day.

Warning About ERCP !!

If the patient has any of the following symptoms within 72 hours after ERCP, call your doctor and seek emergency care immediately:

  • Severe abdominal pain
  • A continuous cough
  • Fever
  • Chills
  • Chest pain
  • Nausea or vomiting
  • Bleeding or vomiting blood
  • Blood in your stool

What are the risks of ERCP?

The risks of ERCP include complications such as the following:

  • Pancreatitis a kind of disease.
  • Infection in the bile ducts or gallbladder.
  • Excessive bleeding, known as hemorrhage.
  • An abnormal reaction to the sedative, including respiratory or cardiac problems.
  • Perforation in the bile or pancreatic ducts, or in the duodenum near the opening where the bile and pancreatic ducts empty into it.
  • Tissue damage from x-ray exposure.
  • Death, although this complication is rare.

If you are also suffering from any of the disease-related to the pancreas of bile duct get your ERCP test done as soon as possible. Now you can even book an online appointment of top and best doctors available on MEDISHALA. Book an appointment today or download Medishsla App on play store.


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