ERCP (Endoscopic Retrograde Cholangiopancreatography) is a diagnostic procedure to visualize the pancreatic and bile ducts near the stomach that are crucial in transporting digestive juices from the liver and pancreas to the intestines. Through this test, the healthcare provider inserts a tube known as an endoscope through the mouth and throat, further down the esophagus, to the stomach until the beginning of the intestine, in order to detect health problems in the liver, gallbladder, and pancreas that could be leading to a serious illness. Subsequently, a small and flexible tube is passed through the endoscope through which a contrasting dye is injected. This helps to aid the X-ray visibility.
Also Read: Liver Function Tests: Know The Types, How It Is Done And What To Expect
Purpose Of ERCP Procedure
Mostly done on an outpatient basis or in some cases as a part of hospital admission, an ERCP enables doctors to assess the condition and functionality of the ducts. ERCP may also be done to investigate abnormal results obtained from blood tests, ultrasounds, or CT scans, or to address problems detected through these diagnostic techniques. The procedure can also assist doctors in determining the need for surgery and the most suitable one needed. Though many alternative approaches and surgical techniques to ERCP exist, this is still the most preferred one owing to its less invasive nature and higher success rate.
Why Is ERCP Done?
Common reasons for performing ERCP can be the following:
- To detect the presence of stones in the bile or pancreas
- Lesions or tumors in the pancreas, gallbladder, or the liver
- Jaundice
- Before or after gallbladder surgery in some situations
- To identify non-cancerous or cancerous lesions
- To address issues that may arise following gallbladder surgery
How Is ERCP Done?
Usually performed in a doctor's office, clinic, or hospital, before the test, the patient is intravenously given a sedative to induce relaxation. In rare cases when general anesthesia is required, the patient will be completely asleep during the procedure. The procedure involves checking on the patient's overall health and he or she may be instructed to refrain from eating and drinking for a specified period before the procedure. Certain medications including blood thinners, supplements, and immune system-affecting drugs may be discontinued. Informing the patient regarding any allergies and side effects is also done. The endoscope is inserted through the mouth, passing through the esophagus to reach the stomach and then the duodenum. This insertion does not interfere with breathing and potential minor discomfort may include a sensation of bloating due to the air used to inflate the duodenum. Sometimes a slight discomfort when the dye is injected for X-ray imaging can be felt. The duration of an ERCP procedure is about an hour, depending on the complexity of the case. Patients are observed in the procedure area for one to two hours after the procedure until the sedative effect disappears. And then, the patients can be driven home.
Post Procedure Precautions
After the procedure, it is advisable to spend the remainder of the day at home. Normal eating and regular medication schedules can be resumed unless advised otherwise by the doctor. Mild throat soreness might persist for a day or two. The patient can resume work after a day's rest but in some cases, overnight hospital stays may be required. ERCP results are communicated on the same day of the test though analysis of biopsy samples may require some days.
ERCP Risks And Results
While complications and risks of ERCP are rare, they can occur in rare cases. The most encountered issue after ERCP is pancreatitis, due to irritation from the X-ray dye or due to side effects of the small plastic tube used during the procedure. Other potential problems may arise if additional treatments are performed during the ERCP (such as stone removal or stent placement) which may carry the risk of bleeding or perforation of the intestine. Another sporadic risk of ERCP is the transmission of infection through the endoscope. If patients experience abdominal pain, fever, vomiting, or blood in their stool, they should contact their doctor immediately.
