What is an ERCP?
An ERCP is a specialized procedure to study the ducts of the gallbladder, pancreas and liver.  An endoscope (small flexible tube about the diameter of the middle finger) is inserted through the mouth, esophagus, stomach, and into the duodenum (first part of the small intestine).  After the small opening into the bile ducts located in the duodenum is visualized, a catheter (very small plastic tube) is inserted into it.  A dye is injected through the catheter into the ducts and x-rays are taken.  This procedure is performed in the x-ray department. 

Why Do I Need It?
An ERCP is done to diagnose diseases of the pancreas, liver, gallbladder and bile ducts.  In many cases gallstones lodged in the bile duct can be removed, avoiding a surgical procedure. 

What Are the Risks?
ERCP is generally a safe procedure when performed by a physician who has had special training and experience in performing it.  Infrequent complications include bleeding, pancreatitis, infection, perforation, reaction to the "dye" used to visualize the ducts and drug reactions to the sedation given.  The "dye" used during an ERCP is an iodine-based product.  Please inform us before your procedure if you are allergic to iodine or iodine dyes. 

Will it Hurt?
While it is normal to have some degree of apprehension prior to your test, you should experience little or no discomfort.  You will be given intravenous sedation before the procedure to help you relax and many patients have no recollection of the test afterward.  One or more of the following medications may be used:  Versed, Demerol and Fentanyl.  If you are allergic to any of these medications, please notify the office before your procedure. 

What Preparation is Needed?
Your stomach should be completely empty for the test, so DO NOT eat or drink anything after midnight on the day of your exam.  You may take any essential medicines, such as heart, asthma, blood pressure and anti-seizure medications.  DO NOT take any aspirin or medicines that contain aspirin for 5 days prior to your procedure.  If you take Coumadin or other blood thinning medication, DO NOT take it for 3 days prior to your procedure. You will not be able to drive for the rest of the day due to the sedation so you will need to arrange for a designated driver to come with you on the day of your test.  Plan on arriving at the hospital 30 to 45 minutes before the time your test is scheduled.

What Can I Expect During the Procedure?
You will be transported from the Endoscopy Department to the X-ray department for this test.  Before the procedure starts, your throat will be sprayed with a numbing medication to help control gagging and you will be given sedation through an IV.  Your blood pressure, pulse, respirations and oxygen level will be monitored continuously during the test.  While you are lying on your stomach, the endoscope is passed through the mouth, then into your esophagus, stomach and duodenum.  You will not experience any difficulty breathing during the test since the endoscope is inserted into the esophagus (food pipe), a separate tube from your wind pipe.  The procedure usually takes between 30 minutes to 1 hour or more to perform.

What Happens After the Procedure?
After your procedure is completed you will be taken back the the Endoscopy Department's recovery area for approximately 30 minutes to 1 hour, where you will be monitored and observed by a Registered Nurse.  You can expect to feel drowsy for several hours afterward.  You will not be able to eat or drink anything for 1 hour after your exam and you will not be able to drive or operate any machinery for the rest of the day.  Your throat may feel slightly sore and you may feel bloated for a while.  You will be given written discharge instructions and appropriate learning material before you go home. 

When Will I Find Out the Results of My Test?
Dr. Imam will talk to you and your designated driver you before you leave and usually preliminary results can be given to you at that time.  If a biopsy was taken during the procedure it will be sent to the laboratory for examination under a microscope.  It will take 3 to 4 days before the report is received from the laboratory.