Endoscopic Retrograde Cholangiopancreatography (ERCP) enables your doctor to diagnose problems in your liver, gallbladder, bile ducts, and pancreas. Your liver makes a liquid called bile that helps with digestion. The gallbladder helps in the storage of bile until it is required for digestion. The bile ducts carry bile from the liver to the gallbladder and small intestine. These ducts are also known as biliary trees. The pancreas is a gland that produces chemicals which helps in digestion and also secretes hormones such as insulin.
ERCP is performed to:
· Diagnose and treat conditions related to pancreas or bile ducts (e.g. stone)
· It is used to evaluate any symptoms or further clarify the abnormal results (e.g. abdominal pain or jaundice).
· Before or after gallbladder surgery.
· Tumors can be diagnosed and then treated with indwelling plastic tubes that are used to bypass a blockage of the bile duct.
Before the procedure
Before an ERCP, patients are given sedatives.
Patients might need to stop consuming their regular medications. It is best to check with your doctor. Patients might also be required to stop taking medicines that control blood clotting temporarily.
Patients must also ask their friends or relatives to drive them home because they will be asked not to drive for 24 hours after the procedure is completed.
Patients must also avoid eating, drinking, smoking, or chewing gum 8 hours before ERCP is performed. This will allow the doctor to look at the intestinal tract properly
ERCP combines the use of X-rays and an endoscope, which is a long, flexible, lighted tube. Through the endoscope, the physician can see the inside of the stomach and duodenum, and inject dyes into the ducts in the biliary tree and pancreas so they can be seen on X-rays.
During the procedure, you will lie on your side. You will be given local anaesthesia and a sedative to relax. Your doctor will guide the endoscope through your esophagus, stomach, and duodenum till the spot where the ducts of the biliary tree and pancreas open into the duodenum. Dye is injected and X-ray equipment is used to take pictures. This will give a better view about narrowing, or blockage of the ducts. If required, your doctor can take sample for further evaluation, and remove gallbladder stones or blockage. Once the procedure is done, endoscope will be removed.
The doctor can also place tiny instruments through the endoscope to:
1. Rupture and remove stones.
2. Insert stents to open blocked or narrowed ducts.
3. Eliminate tumors or tissue samples for a biopsy.
After the procedure
After ERCP is completed, patients will have to wait until the sedation or effects of anaesthesia diminish. Patients will probably need to stay in the hospital or outpatient centre for 1 to 2 hours.
After an ERCP, patients may experience:
1. Bloating
2. Nausea
3. Sore throat
Patients are also advised to rest when they return home. Once the sore throat, caused due to instrument insertion, has dissipated, patients can return to their normal diet.
It takes approximately an hour, depending upon the condition for which the procedure is done.
You may feel slight discomfort in the throat and need someone to accompany you home. Your doctor will schedule your follow-up. It is recommended to take rest after the procedure
ERCP is fairly a low-risk procedure that helps doctors identify the cause of certain bile duct and gastrointestinal problems. ERCP might also aid in treating these problems. The doctor can share the findings and treatment options with the patients on the day of the procedure or after they receive the biopsy results.
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