ERCP

ERCP

What is ERCP?

ERCP stands for endoscopic retrograde cholangio-pancreatography. It is a diagnostic procedure that involves X-ray examination of the pancreatic and bile ducts. Before the procedure, these ducts are injected with a dye to enhance visibility. The bile ducts carry bile from the liver, while the pancreatic duct transports pancreatic juice from the pancreas. Both ducts open into the first part of the small intestine, known as the duodenum.

When is ERCP used?

ERCP is employed for various purposes:

- It can help locate and, in some cases, remove gallstones lodged in the bile duct.
- It aids in the detection of conditions such as cancer, infections, and cirrhosis of the liver.
- ERCP is used to investigate jaundice, a condition where the skin and eyes turn yellow due to bile duct blockage.
- It is also utilized to explore unexplained abdominal pain.

Aside from diagnostic purposes, ERCP can alleviate jaundice by extracting gallstones from the bile ducts or by inserting a plastic tube (stent) to bypass a narrowing in the lower bile duct.

How is ERCP performed?

The ERCP procedure takes place in a hospital X-ray department. To allow safe passage of the endoscope, the patient must fast for six hours beforehand.

- The back of the throat is sprayed with a local anesthetic to numb it, making swallowing easier.
- A sedative is administered to induce drowsiness.
- A specialized endoscope is inserted through the mouth and swallowed by the patient, reaching the duodenum.
- Once in place, a thin tube is passed through the endoscope into the ducts leading to the gallbladder and pancreas.
- The dye is injected into the ducts, and X-ray images are captured.
- The endoscopist examines the X-ray images.
- If a stone is present in the bile duct, it may be removed by enlarging the duct's lower end and extracting the stone.
- In cases of duct narrowing, a plastic tube (stent) is inserted to allow bile to drain freely into the duodenum.

After the procedure, the patient may feel drowsy for a few hours. If stones are removed or a stent is inserted, overnight hospitalization may be necessary.

Is ERCP risky?

Diagnostic ERCP is generally safe. However, in rare instances, patients may be allergic to the X-ray contrast dye. Pancreatitis, inflammation of the pancreas, occurs in about 1 percent of cases.

Therapeutic ERCP, used for treatment, carries slightly higher risks, with about 3 percent of patients experiencing complications such as infection, bleeding, or pancreatitis. Most individuals fully recover with medical treatment. Pregnant women should be cautious as the dyes used may pose a risk to the baby. Patients with liver, heart, or kidney diseases should seek specialist advice before undergoing the procedure.