ERCP: Endoscopic Retrograde Cholangiopancreatography
What is an ERCP?
ERCP (endoscopic retrograde cholangiopancreatography) is a specialised procedure using an endoscope to diagnose and treat problems associated with the ducts connected to the liver, gallbladder and pancreas. ERCP uses a combination of Endoscopic placement of instruments, and Xrays to visualise the bile and pancreatic ducts.
Why would I need an ERCP?
Common reasons for performing an ERCP are to look for and remove gallstones from the bile duct, or to manage narrowing (strictures) of the bile duct or pancreatic ducts. Strictures of the bile duct can occur for non cancerous (benign) or cancerous (malignant) reasons.
What is involved in an ERCP?
Prior to an ERCP you will need to have no solid food for 6 hours before the admission time. Water (in moderation) can be taken up to 2 hours before admission.
If you take blood thinning agents such as Warfarin, Pradaxa, Xarelto, Asasantin, Persantin, Plavix or Clopidogrel, it is most likely that you will need to cease these prior to the procedure so you must discuss this with the Mr Lowe. Aspirin (Astrix, Cardiprin, Cartia) is usually ok to continue.
At the time of the procedure you will be made sleepy by an Anaesthetist who will monitor your heart and breathing during the procedure. This is not a General Anaesthetic, but most people do not remember anything of the procedure.
You will be helped into a position lying on your left side, almost on your front and your surgeon will then insert a special Endoscope (a flexible tube with a camera) through the mouth and stomach to the first part of the small intestine (the duodenum) where the bile and pancreatic ducts enter. Catheters and other instruments are then passed down the endoscope and into the bile ducts or pancreatic duct to perform the surgery needed. Usually patients stay in hospital overnight following an ERCP.
Common procedures performed during an ERCP include:
Sphincterotomy. A cut to the muscle at the bottom of the bile duct to increase the size of the opening of the bile duct to enable stones to be pulled from the bile duct to the intestine.
Balloon or Basket extraction. Balloons or Baskets are used to pull stones through a Sphincterotomy into the intestine.
Stent. Stents are plastic tubes, or wire mesh tubes which are used to hold the bile duct open if it is being squashed closed but scarring or cancers.