What is ERCP?
ERCP is a specialized procedure used to examine the bile ducts from the liver, the pancreatic duct and the gallbladder.
How is ERCP performed?
A specialized thin flexible tube called an endoscope is passed through the mouth, esophagus and stomach into the duodenum (first part of the small intestine). The common opening to the ducts from the liver and pancreas (major duodenal papilla) are viewed. A narrow plastic tube called a catheter is then inserted through the endoscope into the ducts. The physician will inject a contrast dye into the pancreatic or biliary ducts and x-rays will be taken. Therapeutic measures may also be performed by the physician depending on the results of the x-rays.
What preparation is required?
An empty stomach is necessary for the best examination. You will be given precise instructions regarding fasting and any other preparations prior to your procedure. It is important you notify your physician about any of the following as it may change instructions you are given:
- Medications – especially aspirin or NSAIDS, anticoagulants, clopidogrel or insulin
- Health conditions or diseases – especially heart or lung conditions
- Allergies to medications or contrast dye
What can I expect during ERCP?
Prior to your procedure, you will change into a gown, your medical history will be reviewed, vital signs taken and an IV will be started. You will speak with a member of the anesthesia team regarding your sedation. Your physician will speak with you regarding your procedure and any concerns you have.
Once in the procedure room, you will be positioned on your abdomen. A bite block will be inserted into your mouth to protect your teeth and you will be given sedation to make you comfortable. Once you are sedated, the endoscope will be inserted into your mouth. The endoscope does not interfere with your breathing, however, you may feel bloated after the procedure due to the air introduced through the endoscope during the procedure.
What are possible complications?
ERCP is a safe and well-tolerated procedure when performed by physicians who are specially trained and experienced in the procedure. Although complications are uncommon, they can occur and include:
- Pancreatitis (inflammation of the pancreas)
- Infection
- Bowel perforation
- Bleeding
- Adverse reactions to sedation or contrast dye
The risks of the procedure vary depending on why the test is being performed, what is found during the procedure, what therapeutic intervention is performed, and the patient’s medical history. Your physician will discuss your likelihood of complications prior to your procedure.
What are the risks of anorectal manometry?
Anorectal manometry is a safe, low-risk procedure and is unlikely to cause any pain. After the examination, you may drive yourself home and go about your normal activities.