Endoscopic Retrograde Cholangiopancreatography (ERCP)

The gastrointestinal (GI) tract contains all the digestive system’s major organs responsible for breaking down food into nutrients to nourish the body. However, disorders affecting the digestive system can range from mild to life-threatening. Some symptoms may be signs of a digestive health problem, so don’t delay care. See our healthcare providers at Desert Care Network in Coachella Valley for proper diagnosis and treatment if you experience:

  • Chronic constipation
  • Diarrhea that lasts more than four weeks
  • Frequent heartburn
  • Jaundice (yellowing of the eyes and skin)
  • Rectal bleeding
  • Trouble swallowing
  • Unexplained abdominal pain
  • Unexplained weight loss
  • And other unusual digestive issues

What Is an ERCP Procedure?

An endoscopic retrograde cholangiopancreatography (ERCP) may be recommended to find the cause of jaundice or unexplained abdominal pain. It aims to diagnose and treat conditions affecting the bile and pancreatic ducts. The ERCP uses a combination of:

  • X-ray imaging – the use of ionizing radiation to generate images of the body.
  • Endoscopy – an imaging test involving the use of a long, thin tube with a small camera (endoscope) inside. This tube will be passed through the mouth or other natural openings in the body.

The digestive system’s liver and pancreas produce bile and pancreatic juice, respectively, to help in the digestion process. Bile ducts are tubes that carry bile from the liver to the gall bladder and small intestine. These ducts can become inflamed, narrowed or blocked due to tumors, gallstones, infections, scar tissue and other conditions. Doctors may recommend ERCP if they suspect that a patient’s bile or pancreatic ducts are blocked.

ERCP can help doctors find:

  • Bile duct stones or blockages
  • Bile duct infection
  • Fluid leakage from the pancreatic or bile ducts
  • Pancreatic duct narrowing or blockages
  • Tumors

Is ERCP a Major Surgery?

A major surgery is an intensive procedure that typically involves opening the body to access the internal body part that needs to be treated. Major surgeries usually require anesthesia or respiratory assistance. On the other hand, the ERCP procedure is a minimally invasive procedure that involves minimal incisions, where a medical catheter is inserted to access a body’s internal organ for diagnosis or treatment procedure.

ERCP takes about two hours. Here are some things you can expect during ERCP:

  1. An intravenous (IV) line will be placed into your arm where sedatives will be administered to help you relax.
  2. A liquid anesthetic will be sprayed into the back of your throat to prevent gagging as the endoscope is guided down the throat. Since you will not be able to swallow, the saliva that collects in your mouth will be suctioned as needed.
  3. The endoscope will be guided down the esophagus into the stomach and small intestines.
  4. A monitor shows the video from the endoscope for your surgeon’s viewing as they locate the bile and pancreatic ducts.
  5. Your surgeon will insert a catheter through the endoscope into the ducts. A contrast dye will be released in these areas to make the ducts clearer for X-ray imaging.
  6. Procedures such as tissue sampling, stone removal and other treatments will be performed as needed.

What to Expect After ERCP?

You may need to stay at the hospital for up to two hours to wait for the effects of anesthesia or sedation to wear off. It is normal to experience nausea or bloating after the procedure, as well as a sore throat for up to two days. You can resume a normal diet once your swallowing normalizes. Make sure to follow your doctor’s post-ERCP instructions to help you recover.

Seek medical attention immediately if you experience any of these symptoms after ERCP:

  • Blood, tar-colored or black stool
  • Breathing problems
  • Chest pain
  • Fever
  • Swallowing problem
  • Vomiting
  • Worsening abdominal pain

What Is the Difference Between ERCP and MRCP?

Both ERCP and magnetic resonance cholangiopancreatography (MRCP) are used to diagnose problems in the pancreatic and bile ducts. Compared with ERCP, MRCP is noninvasive and uses a magnetic resonance imaging (MRI) machine to produce images of the ducts. A doctor may recommend MRCP if a patient is unable to get ERCP, such as when the patient is allergic to contrast dye. However, MRCP can only be used for diagnostic imaging and not treatments.

An MRI machine includes a table where an MRCP patient will lie flat on their back. This table will slide into the machine to take multiple images of the digestive ducts. The patient will be asked to stay still during the entire test and to hold their breath for 12 to 18 seconds several times. The entire process may take up to 60 minutes.

Recommendations

No digestive problem is too small or too big for Desert Care Network. If you are worried about recurring symptoms affecting your digestive system, now is an excellent time to speak with one of our gastroenterologists for proper diagnosis, evaluation and treatment. Please don’t delay care. We are here always to help take care of your digestive health.

Sources:
Canadian Cancer Society
GastroMD
Healthline
Johns Hopkins Medicine
National Institute of Diabetes and Digestive and Kidney Diseases
NHS
Medical University of South Carolina
MedStar Health
OakBend Medical Group
U.S. Food & Drug Administration

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