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Endoscopic Retrograde Cholangiopancreatography

Endoscopy anatomySouthern California Gastroenterology Services

Endoscopy refers to a technique to look inside the body with the use of an endoscope, which is inserted directly into the body. The physician uses an endoscope to diagnose and examine the area. An endoscope is a long, thin, flexible tube with a tiny video camera and light at the end. In this procedure, an endoscope is passed through the first part of the digestive system (esophagus, stomach, into the first part of the small intestine) to allow doctors to diagnose problems with the pancreas, gallbladder, and liver. The liver is a large organ that creates bile, which aids in digestion. Bile ducts (Cholangio-) carry bile from the liver to the gallbladder and small intestine. The pancreas aids in digestion by producing chemicals and hormones.

Why an ERCP?

A small amount of dye is released into the common bile duct and x-rays are taken after its release. The dye outlines the bile ducts and pancreatic duct and can show whether the duct is narrowed or blocked. This procedure is used to locate gallstones and evaluate the causes of jaundice (yellow eyes) and chronic abdominal pain. The doctor has the ability to widen the bile duct opening and pull the gallstones into the intestine. A small brush can be followed through the tube to take samples of cells for a biopsy and further testing as well.

Preparing for Your ERCP

Patients will be given specific instructions to prepare for their scheduled ERCP. These instructions will include diet scheduling the day before and day of your procedure, as well as specifics regarding medication. The stomach and duodenum must be empty for a safe and accurate test, so a clear liquid diet is usually assigned. Since the procedure requires sedatives, patients are required to have a licensed driver take them back home (taxis are not allowed).

During Your ERCP

Steps will be taken to ensure that you will be as comfortable as possible. Medication will be given to numb the back of the throat and a sedative will be given to help you relax during the exam. While on your side, you will swallow the endoscope and the physician will guide it until it reaches the spot where the pancreas opens into the duodenum. You will then turn on your stomach and the physician will pass a plastic tube through the scope to inject the dye.

An ERCP is a relatively safe procedure, but with any medical procedure, complications may occur. Be sure to discuss any concerns or specifics about the procedure with your doctor.

After the ERCP

Once the procedure is complete, expect to stay in the recovery area until the sedative wears off (1-2 hours). Minor problems may arise, such as tenderness where the sedative was injected and mild discomfort in the throat. Plan on resting for the remainder of the day after your procedure. Further instruction may be given by your physician.

For Patients

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