Endoscopic Retrograde Cholangiopancreatography
Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic procedure performed to detect abnormalities in the liver, gallbladder, pancreas and bile ducts. It is performed using an endoscope (a lighted tube snaked down the esophagus) and X-rays to obtain a detailed view of the gastrointestinal region.
Reasons for Retrograde Cholangiopancreatography
ERCP is performed to detect, diagnose and treat various gastrointestinal-tract abnormalities, including gallstones, cysts, and benign or malignant tumors. ERCP may be recommended for patients who have the following symptoms:
- Loss of appetite
- Sudden, unexplained weight loss
- Darkened urine
- Severe abdominal pains
- Light-colored stool
The abdominal pain that often precipitates ERCP is usually in the middle or upper-right of the stomach.
The Retrograde Cholangiopancreatography Procedure
With the patient lying on the stomach or left side, intravenous sedation is administered. An endoscope is inserted through the mouth and into the esophagus, and then snaked down into the duodenum, the uppermost part of the small intestine. A catheter is inserted into the endoscope, and advanced into the ducts leading to the pancreas and gallbladder. A dye is injected into the ducts to enhance visualization, and X-rays of the area are taken. In addition to receiving clear images of any abnormalities in the region, the surgeon is able to insert tiny instruments through the endoscope to perform any necessary tasks, including the following:
- Removing tissue for biopsy
- Removing abnormal growths
- Removing or crushing gallstones
- Widening the bile duct with a stent
- Draining the bile duct or other blocked areas
- Diagnosing various conditions (such as biliary cirrhosis and sclerosing cholangitis)
ERCP takes from half an hour to 2 hours to complete, depending on whether, and how many, surgical tasks are necessary. Post-procedure, a patient may have a sore throat, nausea, bloating or gas. These side effects are normal, and should resolve quickly.
Risks of Retrograde Cholangiopancreatography
Although ERCP is generally considered safe, as with any medical or surgical procedure, there are inherent risks, including the following:
- Adverse reactions to anesthesia, dye or medication
- Excessive bleeding
- Perforation of the bowel
In most cases, recovery from ERCP is quick, although eating a light diet, resting, and refraining from driving are recommended until the following day.