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Endoscopic Retrograde Cholangiopancreatography (ERCP)

GI Endoscopy in Jackson, WY

Endoscopic retrograde cholangiopancreatography (ERCP) is a medical procedure that uses upper gastrointestinal (GI) endoscopy, as well as x-rays, to treat issues with bile and pancreatic ducts. Bile ducts are tubes that bile uses to travel through your liver, gallbladder, and duodenum. Pancreatic ducts are tubes that move pancreatic juice from the pancreas to the duodenum.

Why Doctors Choose to Use ERCP

In addition to treating problems of the bile and pancreatic ducts, doctors use ERCP to identify problems of the bile and pancreatic ducts if they expect to treat these problems during the course of the procedure.

ERCP is performed by doctors when bile or pancreatic ducts have become narrowed or blocked due to:

  • Gallstones in the gallbladder that become stuck in the common bile duct
  • Chronic pancreatitis
  • Acute pancreatitis
  • Pancreatic pseudocysts
  • Tumors or cancers of the pancreas
  • Tumors or cancers of the bile ducts

I’m Interested In ERCP, How Do I Prepare?

If you are thinking about the ERCP procedure, consult with your physician, make arrangements to be driven home, and listen closely to all of your doctor’s instructions. When speaking to your doctor, make sure to discuss any allergies and medical conditions you have and all prescribed and over-the-counter medicines, vitamins, and supplements you are currently taking. This includes:

  • Aspirin
  • Arthritis medicines
  • Blood pressure medicines
  • Blood thinners
  • Diabetes medicines
  • Ibuprofen
  • Naproxen

You might be asked to stop taking medication that can impact blood clotting or interact with sedatives. If you think you are or might be pregnant, make sure you tell your doctor. If you are pregnant and need ERCP, the doctor might alter the procedure to protect the fetus from x-rays. According to research, ERCP is generally safe during pregnancy.

After undergoing ERCP, the sedatives or anesthesia used during the procedure will affect your ability to drive for 24 hours. This is why you need to arrange a ride home after your procedure. You also can’t eat drink, smoke, or chew gum during the 8 hours before ERCP because the doctor won’t be able to clearly view your upper GI tract.

How Is ERCP Performed?

Doctors trained to perform ERCP do the procedure at a hospital. A sedative is given to you through an intravenous (IV) needle. These keep you relaxed and comfortable during the procedure. You will also be given liquid anesthetic to gargle with, or a spray anesthetic that is applied to the back of your throat. The anesthetic helps prevent gagging during the procedure by numbing your throat.

While you lie on the examination table, an endoscope will be carefully fed down your esophagus, through your stomach, and into your duodenum. A video image is sent to a monitor from a small camera mounted on the endoscope. The endoscope pumps air into your stomach and duodenum, which makes it easier for your doctor to see.

During the ERCP procedure, your doctor will:

  • Find the opening where the bile and pancreatic ducts empty into the duodenum.
  • Put a thin, flexible tube called a catheter through the endoscope and into the ducts.
  • Inject a special dye known as contrast medium into your ducts through the catheter. This makes it easier to see the ducts on x-rays.
  • Use fluoroscopy, a type of x-ray imaging, to check out your ducts and look for narrowed areas or blockages.

Your doctor might put tiny tools through the endoscope to:

  • Open blocked or narrowed ducts.
  • Break-down or remove stones.
  • Remove tumors from the ducts.
  • Insert stents that stop bile leaks that can happen after gallbladder surgery.

What Is the Recovery Process Like After ERCP?

You can expect the following things after ERCP:

  • You will likely stay at the hospital for 1 to 2 hours after the procedure. This is to allow the sedatives and anesthesia to wear off. Some people require an overnight stay in the hospital after the procedure.
  • A short period of bloating or nausea.
  • Sore throat for 1 to 2 days.

You will need to rest at your house for the remainder of the day after your procedure, and you can resume your regular diet once your throat feels normal again. Follow all of the care instructions you are given by your doctor.

Some of the results from the procedure are immediately available. If your doctor performed a biopsy, a pathologist will have to examine the tissue. The results of the biopsy can take a few days or longer to come back.

Risks of ERCP

The following are potential complications that can occur:

  • Bile ducts or gallbladder infection
  • Abnormal reaction to the sedative
  • Tissue damage caused by x-ray exposure
  • Excessive bleeding
  • Perforation in the bile or pancreatic ducts, also in the duodenum
  • In rare circumstances, death

According to studies, the complications listed above occur in about 5 to 10 % of ERCP procedures. If you experience any of the following symptoms after ERCP, immediately seek medical attention:

  • Chest pain
  • Fever
  • Growing abdomen pain
  • Difficulty breathing
  • Increasing pain in your throat
  • Bloody or black stool
  • Bloody Vomit

Contact St. John's Surgical Specialists to find out how our board certified surgeons can help with your condition. Call 307.739.7690 today to speak with our friendly medical professionals in Jackson Hole.