ERCP Procedure for Pancreatic and Bile Duct Conditions

Sometimes, traditional imaging such as MRI and CT scan is not able to provide a precise diagnosis and an endoscopic retrograde cholangiopancreatography (ERCP) might be required to help with diagnosis and treatment.

Learn about the ERCP procedure at Advent Health Center for Interventional Endoscopy (CIE) and the benefits of this minimally invasive care option.

What is an ERCP?

ERCP is the medical abbreviation for endoscopic retrograde cholangiopancreatography. It’s a minimally invasive procedure used to diagnose and treat conditions in the bile and pancreatic ducts, and occasionally liver and gallbladder. Combining endoscope with X-ray, ERCP lets your doctor look inside these digestive system organs and check for problems.

Common Reasons to Get an ERCP Procedure

You may need an ERCP procedure if you have:

• Blockages or stones in the bile or pancreatic ducts
• Cancer in the liver, pancreas or bile ducts
• Fluid leakage from the bile or pancreatic ducts
• Infection in the bile ducts
• Inflammation of the pancreas (pancreatitis)
• Unexplained abdominal pain or yellowed skin or eyes (jaundice)

ERCP Treatments for Digestive System Organs

ERCP was originally developed to help with diagnosis of digestive health conditions, but it is now exclusively used as a therapeutic modality. With therapeutic ERCP, we take X-rays of your duct system, plus treat affected areas.

Your duct system includes:

• The bile duct, which drains the gallbladder and liver
• The pancreatic duct, which drains the pancreas
• The papilla, which drains into the first part of the small intestine (duodenum)

Here are some examples of the types of treatment you can receive with ERCP:

• Stone removal from the bile and pancreatic duct system
• Cholangioscopy (SPYGlass) to treat a variety of bile duct diseases
• Sphincter of Oddi dysfunction (SOD) treatment
• Sphincterotomy to enlarge the papilla opening
• Stent placement to help with bile and pancreatic duct drainage
• Tissue samples (biopsies) to check for cancer
• Ampullectomy (papillectomy) to remove tumor growths

Preparing for the ERCP Procedure

For a successful ERCP procedure, you need an empty stomach. That means you can’t eat or drink anything (even water) for at least eight hours before the procedure.

Make sure you discuss your medical history with your doctor beforehand, including any major diseases you may have. Provide your doctor with a list of your current medications and allergies, so they can keep you safe.

Your doctor will give you detailed instructions to follow before your ERCP.

How ERCP Works

During the ERCP procedure, you start out lying on your stomach or left side. Your doctor (endoscopist) may spray your throat with a local anesthetic. Then, you will receive general anesthesia to put you to sleep.

After sedation, your endoscopist passes a thin, flexible tube with a camera (endoscope) through your mouth, esophagus and stomach, into the duodenum. There are different accessory tools the endoscopist can use to complete the procedure, including a balloon, wire, or sphincterotomes.

The endoscopist injects dye, or contrast material, through the endoscope, so they can take pictures of the specific area and perform other treatment if needed.

The length of your procedure depends on the complexity of the treatment but may last 30–90 minutes.

What to Expect After ERCP

Because you receive anesthesia for ERCP, you have to stay in the recovery area afterwards. We monitor your health until the medication’s effects wear off.

You shouldn’t have any side effects. Your throat may be a little sore, and you may have some mild bloating. Serious complications — such as pancreatitis, bleeding, bowel perforation and infection — aren’t common, but they can rarely happen. Your doctor will always discuss these with you before ERCP, and weigh any risks with the benefits.

After ERCP, you can eat like normal that same day, as long as your doctor approves.

You won’t be able to drive right away — even if you don’t feel tired. You should arrange for someone to bring you home and stay with you that day since sedatives can affect your judgment and reflexes.

If your treatment requires it, you may be admitted to the hospital for observation. Most patients get discharged the following day, as long as they feel well.

Your doctor will usually discuss results of the procedure on the same day, though some tests can take a few days for the results to return.

Advanced Endoscopies for Complex GI Diseases

As the region’s only complex endoscopy center, the AdventHealth CIE at Tampa is known for combining endoscopy with minimally invasive surgery. Here, we diagnose and treat a variety of complex gastrointestinal (GI) diseases. Our endoscopic interventions, including ERCP, provide an alternative to more invasive surgeries.

To schedule an appointment with our skilled team of endoscopists, call the CIE at Call813-615-7028.