What is an ERCP?

An ERCP is an endoscopic retrograde cholangiopancreatogram which is used to diagnose problems associated with the biliary and pancreatic ductal systems.  ERCP combines the use of x-rays and a duodenoscope, which is a long, lighted tube with a camera built in to it.  The physician can see the inside of the stomach and duodenum, and inject dye into the ducts of the biliary tree and pancreatic ducts so they can be seen on x-ray.

During the procedure, you will be given general anesthesia.  You will be positioned onto your left side almost completely on your stomach after you are asleep by the endoscopy team.  The scope is passed through your mouth, down your esophagus and through your stomach into the duodenum (first part of the small intestine).  A small, plastic catheter is passed through the scope into the biliary ducts.  Dye is injected through this small catheter for x-ray viewing. 

If the exam shows gallstones or a narrowing of the ducts, the physician can insert instruments through the scope to remove or relieve the obstruction.  If deemed necessary, a stent can be left in place to keep a duct open.  Also, tissue samples (biopsies or brushings) can be taken and sent to the lab for testing. 

An ERCP can take as little as 30 minutes to as long as  2 hours or more.  

Why do doctors order an ERCP?

This procedure allows the doctor to diagnose and treat conditions of the bile ducts, including gallstones, inflammatory strictures (scars), leaks (from trauma or surgery), and cancer.