Endoscopic Retrograde Cholangiopancreatography, popularly known as ERCP, is a specialised technique used to diagnose and treat the diseases of the liver, pancreas, gallbladder and biliary system.
ERCP combines X-ray and the usage of an endoscope. The endoscope is a thin and long flexible tube that has a camera and light at the end of it that helps the doctor look at the organs clearly.
During the procedure, the doctor guides the endoscope through your mouth and throat, then down the oesophagus, stomach, and the first part of the small intestine. With the help of the endoscope, the doctor can view the inside of the organs and check for problems.
Why might I need ERCP?
You may need to undergo ERCP to find the cause of unexplained jaundice (yellowing of the eyes and skin) and abdominal pain.
This diagnostic procedure can also be used to get more information if you have pancreatitis or cancer of the pancreas, liver or bile duct.
ERCP can also help in detecting other complications such as:-
- Tumours
- Infection in the bile ducts
- Blockage or stone in the bile ducts
- Fluid leakage from the bile or pancreatic ducts
- Blockages or narrowing of the pancreatic ducts
Apart from all the above, the doctor may recommend this procedure to diagnose and detect other diseases and complications.
How do I prepare for ERCP?
The doctor ensures a few things before you undergo the procedure. This may include ensuring if you have:-
- Pregnancy
- Lung conditions
- Heart conditions
- Allergy to any medications
Also, if you have diabetes and use insulin, you may need to adjust the dosage of insulin, especially on the day of the procedure. However, your doctor will help you with the adjustment.
Do carry your diabetes medication, so that you can take it post-procedure. Also, if you take blood-thinning medicines, your doctor may ask you to stop them or prescribe an alternative for the same.
Furthermore, do not stop any medication without first consulting with your primary or referring doctor. Do not eat anything eight hours before you undergo the procedure.
Also, bring a friend or a family member with you who can take you home post-procedure.
What happens during ERCP?
An ERCP may be performed on an outpatient basis or as part of your stay at a hospital. The procedure may vary depending on your condition and the doctor’s practices.
Generally, during the procedure, a gastroenterologist uses a special medical instrument called an endoscope to examine the inside of the digestive system.
After that, the doctor identifies the place where the bile duct comes into the intestine and then feeds a tiny catheter into the duct and squirts in a contrast agent while X-rays are taken.
The contrast agent helps the doctor to see the bile ducts, the gallbladder and the pancreatic duct on the X-rays. Once the source of the problem is detected, the doctor starts the treatment process.
What happens after ERCP?
After completion of the procedure, the doctor shifts you to the recovery room for about 1-2 hours for observation. You may have soreness in your throat temporarily.
However, you can suck on throat lozenges to relieve the pain. After a few hours, you can return to your home with the person you came with. The doctor also recommends that someone should stay with you for 24 hours after the procedure.
You should avoid driving for at least 8 hours. The results are sent to your primary or referring doctor, who discusses them with you. If results indicate that prompt medical intervention is required, the necessary arrangements are made and your referring doctor is notified of the same.
If you feel any of the following after undergoing ERCP, do consult your doctor immediately:-
- Fever or chills
- Abdominal pain
- Nausea and vomiting
- Trouble swallowing
- Black, tarry or bloody stool
- Throat or chest pain that worsens
- Swelling, redness, and bleeding from the IV site
The doctor may give you other instructions based on your condition after the procedure.
Risks of ERCP
Some of the possible risks of ERCP may include the following:-
- Bleeding
- Infection
- Inflammation of the pancreas or gallbladder
- Collection of bile outside the biliary system
- A tear or lining of the upper section of the small intestine, oesophagus or stomach
You may not be able to undergo the ECRP if:-
- You have had gastrointestinal surgery that has blocked the ducts of the biliary tree.
- You have pouches in your oesophagus or another abnormal anatomy that makes the test difficult to perform.
- You have barium within the intestines from a recent barium procedure.
Apart from all the above-mentioned, there may be other risks depending on your condition. Be sure to discuss all your concerns with the doctor before you undergo the procedure.
