Services

Endoscopy Services

Endoscopic Retrograde Cholangiopancreatography (ERCP)

What is endoscopic retrograde cholangiopancreatography (ERCP)?
ERCP is a way to examine your pancreas, pancreatic duct, common bile duct, and/or sphincter of Oddi. Your doctor uses a long, narrow tube called an endoscope to look at these parts of your body. He or she may use contrast dye and x-rays to highlight these. Your doctor also may use ERCP to try to remove any stones or blockages he or she may find.

When is it used?
The doctor may suggest an ERCP if:

  • You have particular forms of jaundice.
  • He or she suspects you have a stone lodged in the common bile duct.
  • You have a blockage in the pancreatic duct.
  • You have a sphincter of Oddi that is too tight.
  • You have a growth of tissue in the bile duct or pancreatic duct.

Examples of alternatives are:

  • Having a common bile duct exploration.
  • Having a CT scan of the abdomen.
  • Having similar x-rays done through a needle placed in the bile duct through the liver (a procedure called a percutaneous transhepatic cholangiogram.)
  • Choosing not to have treatment, while recognizing the risks of your condition.

You should ask your doctor about these choices.

How do I prepare for an ERCP?
Follow the doctor’s instructions. Eat a light meal the night before the operation and do not eat or drink anything after midnight the night before the procedure. Plan for care and recovery time after the operation is over.

What happens during the procedure?
You will be given a sedative to relax you. The doctor will insert a tube into your throat and down your esophagus (swallowing tube) and guide it through your stomach and small intestine until it reaches the point at which the common bile duct opens into the intestine (the sphincter of Oddi). The doctor then will pass a smaller tube through the first tube and guide it up the common bile duct to look for stones, narrow places, or blocked portion. Fluoroscopy, a motion picture x-ray, is used to guide the tube.

The doctor may inject some dye into your common bile duct and/or pancreatic duct to highlight any abnormal growths or structures on an x-ray. If the x-ray or tube uncovers stones, the doctor may use a tool to break up and move these into the intestine. He/she also may enlarge the opening of the sphincter of Oddi by cutting into the muscle wall to allow the stones to pass through to the intestine more easily.

What happens after the procedure?
You will be observed for one to four hours and then released to go home. Because you must not drive or do anything that requires coordination or quick response, you must have someone with you to visit with the doctor and drive you home. If the doctors cuts into the sphincter, you may need to stay overnight in the hospital. Ask you doctor what steps you should take and when you should come back for a checkup.

What are the benefits of ERCP?
Your doctor may understand your problem better and be able to suggest further care. You may get relief from the problem. If you have an obstruction, the doctor may relieve it without having to resort to abdominal surgery, with its accompanied discomfort, risks, longer hospital stay and expense.

What are the risks associated with ERCP?

  • Your esophagus, stomach, intestine and/or common bile duct may be hurt or punctured.
  • You may develop inflammation in the liver, common bile duct, or pancreas.
  • The procedure may not work: if there is a blockage or if you have stones, your doctor may not be able to clear either one.
  • There is a risk of infection and bleeding.

You should ask your doctor how these risks apply to you.

When should I call the doctor?
Call the doctor if:

  • You develop severe abdominal pain.
  • You have persistent nausea or vomiting.
  • You develop a fever.

Call the doctor during office hours if:

  • You have questions about the procedure or its result.
  • You want to make another appointment.

For more information, call Mercy Endoscopy Services at 641.422.7394 or Dr. Sondhi’s office at 641.422.6783.