ERCP
Diagnosis and treatment for the bile and pancreatic ducts, usually in a single procedure.
ERCP, or endoscopic retrograde cholangiopancreatography, uses an endoscope passed through the mouth to the first part of the small intestine, where the bile duct and pancreatic duct drain. A thin catheter is guided into the ducts, contrast dye is injected, and X-ray images show where a duct is blocked or narrowed. The advantage of ERCP is that most problems it finds can be treated during the same procedure.
Why It Might Be Recommended
- Stones in the bile duct
- A narrowing (stricture) of the bile or pancreatic duct
- A blockage causing jaundice or abnormal liver tests
- A bile leak, sometimes after gallbladder surgery
- Placement, exchange, or removal of a stent
- Sampling a stricture to determine its cause
ERCP in Altered Anatomy
Prior surgery on the stomach or small intestine, such as gastric bypass, can make the ducts difficult or impossible to reach with a standard ERCP. Dr. Mina Elnemr performs ERCP in patients with altered anatomy, a procedure that relatively few gastroenterologists in the region offer. If you have been told ERCP is not possible because of a previous surgery, it is worth asking us.
Risks
ERCP is more involved than a routine upper endoscopy, and it carries more risk. The most common complication is pancreatitis, an inflammation of the pancreas that is usually mild but can occasionally be serious. Bleeding, infection, and perforation are less common. Your physician will discuss your specific risks and why the procedure is recommended before you proceed.
Preparing for It
Preparation follows our upper endoscopy instructions, which cover ERCP as well. Tell us ahead of time if you take blood thinners, diabetes medications, or GLP-1 medications, and let us know about any allergy to contrast dye or iodine.
You must have a responsible adult to drive you home. The procedure is done under sedation.
Afterward
Some throat soreness and bloating are common. You will be monitored after the procedure, and depending on what was done, some patients stay for observation. Severe abdominal pain, fever, chills, vomiting, or black or bloody stools after an ERCP needs prompt attention. During office hours, call us. After hours, go to the nearest emergency room, since we do not have a physician on call.
For Referring Physicians
We accept referrals for ERCP, including patients with surgically altered anatomy. Please fax the referral, imaging reports, and recent labs to 813-644-3307, or call 813-600-3709 to discuss a patient.
Related: Endoscopic ultrasound (EUS) · Upper endoscopy · Dr. Mina Elnemr