ERCP (Endoscopic Retrograde Cholangiopancreatography)

What is ERCP?

Endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic technique used to diagnose and treat conditions related to the biliary tree, pancreas and liver. It is a technique that combines both endoscopy (use of a long flexible tube with a light and camera at the tip) and x-rays to allow a specialist to see and examine the drainage tubes (ducts) of the liver, gallbladder and pancreas.

Bile is made in the liver and is continually produced throughout the day. It is released into the small bowel (duodenum) to allow digestion of food. It can be stored in the gallbladder. The pancreas produces enzymes that also allow digestion of food and are released into the small bowel at the same point as the bile. The point at which the bile duct and pancreatic duct drain into the duodenum is called the ampulla.

ERCP are often performed as a day procedure, meaning that patients do not need to stay in hospital overnight.

ERCP is a highly specialised and technical procedure and should be performed by specially trained and experienced specialists.

Why do an ERCP?

ERCP is a nonsurgical method to treat conditions of the liver, gallbladder and pancreas.

These conditions include:

  • Gallstones blocking the bile ducts

  • Infection of the bile ducts and liver (cholangitis)

  • Inflammation of the pancreas (pancreatitis)

  • Narrowing of the bile duct (stricture)

  • Treatment of complications following gallbladder operation (cholecystectomy)

  • Cancer of the pancreas, bile ducts or ampulla

How is the ERCP procedure performed?

ERCP is usually performed in a recognised hospital due to the complex nature of the procedure as well as the specialised equipment used.

The ERCP procedure is often performed as a day procedure, meaning that patients do not need to stay in hospital overnight.

Sedation/anaesthetic is given during the procedure.

The procedure is performed with the patient either lying on their stomach or on their left side. The instrument is then inserted through the mouth, and passed through the oesophagus, stomach and duodenum.

Antibiotics may be given before or during the procedure.

What are the complications of an ERCP?

ERCP is a well-tolerated procedure when performed by an experienced and trained specialist. However complications can occur in up to 1 in 20 patients (5%).

The most common complication is pancreatitis (inflammation of the pancreas which can occur on average in 1 in 20 patients having the ERCP procedure. If pancreatitis occurs, it often requires the patient to stay in hospital until it resolves (typically 1-3 days).

Other less common complications include bleeding, infection and tear(perforation) of the wall of the gastrointestinal tract.

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