An endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic procedure which enables the physician to evaluate the biliary tree, the gallbladder, and the pancreatic ducts. The physicians of Premier Gastroenterology Associates perform ERCP procedures regularly. The biliary tree is a system of ducts draining bile from the liver into the duodenum (an initial segment of the small bowel). Bile is a dark yellow liquid which helps in digestion of fat. The gallbladder is a small organ connected to the biliary tree, and it serves as a storage container for bile. Pancreatic ducts drain the juice produced by the pancreas into the duodenum. Pancreatic ducts are connected to the biliary tree. Pancreatic juice contains substances which are essential for digestion of food in the small bowel.
An ERCP is used primarily to diagnose and treat diseases of the biliary tree and pancreatic ducts, including gallstones, inflammatory strictures (narrowing of the ducts), leaks (from injury or surgery), and cancer. ERCP combines the use of x-rays and an endoscope, which is an instrument similar to the one used for EGD and colonoscopy. Through the endoscope, the physician can see the inside of the stomach and duodenum, and can inject dyes into the ducts of the biliary tree and pancreas so they can be seen on x-rays.
During the procedure, patients are sedated with intravenous medications. The risks of ERCP are higher than those of EGD or colonoscopy and include pancreatitis (inflammation of the pancreas), bleeding, perforation of the intestine or biliary tree, and infection.
At least a week prior to ERCP, you should notify the physician performing the procedure (or nurse) if taking medications for diabetes (oral or injectable) and/or anticoagulants (“blood thinners”) such as Coumadin (Warfarin), Heparin, Lovenox (Enoxaparin), Plavix (Clopidogrel), Pradaxa (Dabigatran) or Ticlid (Ticlopidine). Also, you should notify your physician of taking Aspirin, Ibuprofen, Advil, Naprosyn, Voltaren, and other similar anti-inflammatory medications.
For details concerning the technique and indications for ERCP, as well as risks of the procedure, please click on this link to the American Gastroenterological Association web site.