Endoscopic Retrograde Cholangiopancreatography
Endoscopic retrograde cholangiopancreatography (ERCP) is a test that allows the doctor to see the bile and pancreatic ducts. It is done with a flexible, lighted tube called an endoscope. X-rays are also used.
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Reasons for Procedure
This procedure is done to diagnose and treat problems of the bile and pancreatic ducts, such as narrowing and blockages from:
- Inflammation of the pancreas
- Surgical complications
- Tumors or cancers
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Problems from anesthesia
- Damage to the esophagus, stomach, small intestine, or bile duct
Things that may raise the risk of problems are:
- Abnormal anatomy
- Chronic diseases, such as diabetes or obesity
What to Expect
Prior to Procedure
The care team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before the procedure
- Fasting before the procedure, such as avoiding food or drink after midnight the night before
- Whether you need a ride to and from the procedure
The doctor may give:
- A sedative—you will feel relaxed
- Local anesthesia—the throat will be numbed
If ERCP will take a long time, general anesthesia may be used. You will be asleep.
Description of the Procedure
An endoscope will be put into the mouth. It will be passed through the stomach until it reaches the small intestine. Images will be seen on a nearby monitor. Air will be passed through the scope. This will help the doctor view the area. A tube will be passed through the endoscope and into the ducts. A contrast material will be injected through the tube. This will make it easier to see the ducts with an X-ray. X-rays will be taken.
If needed, tiny tools may be passed through the endoscope to open blocked or narrowed ducts or remove stones or a tumor. A biopsy may also be done.
The tools and scope will be removed.
How Long Will It Take?
It will take 30 minutes to 2 hours.
Will It Hurt?
Throat pain is common in the first few days. Medicine and home care can help.
Average Hospital Stay
Most people can go home the same day. If other procedures were done during ERCP, you may need to stay longer.
At the Care Center
The staff may give you pain medicine.
It will take the rest of the day to recover. A normal diet can be resumed when swallowing has returned to normal.
Call Your Doctor
Call your doctor if you have:
- Signs of infection, such as fever and chills
- Vomiting blood
- Severe belly pain
- Black, tar-like stools or bloody stools
If you think you have an emergency, call for medical help right away.
American Gastroenterological Association
American Society for Gastrointestinal Endoscopy
Canadian Digestive Health Foundation
ERCP (endoscopic retrograde cholangiopancreatography). National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/diagnostic-tests/endoscopic-retrograde-cholangiopancreatography. Accessed January 11, 2021.
Gallstones. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/gallstones. Accessed January 11, 2021.
Katzarov A, Dunkov Z, et al. How to measure quality in endoscopic retrograde cholangiopancreatography (ERCP). Ann Transl Med . 2018 Jul;6(13):265.
Understanding ERCP. American Society for Gastrointestinal Endoscopy website. Available at: https://www.asge.org/home/for-patients/patient-information/understanding-ercp. Accessed January 11, 2021.
Last reviewed February 2020 by EBSCO Medical Review Board Marcin Chwistek, MD