ERCP

Endoscopic retrograde cholangiopancreatography (ERCP)

What is ERCP?

ERCP is a procedure in which endoscopy and x-rays are used together for diagnosis and treatment in gallbladder and pancreatic diseases.

What are bile duct and pancreatic duct?

Bile ducts carry bile from the liver to the gallbladder and duodenum. The pancreatic duct carries the pancreatic fluid to the duodenum. The common bile duct and the main pancreatic duct unite before entering the duodenum.

Why is ERCP done?

ERCP examination is performed for imaging the bile and pancreatic ducts, detecting and treating problems. ERCP is not used much for diagnostic purposes only. More noninvasive tests are preferred for diagnostic purposes. At the same time, different treatments can be applied during the ERCP procedure. ERCP can be applied in the cases listed below;

v  Gallstones blocking the main bile duct

v  Evaluation of unexplained acute pancreatitis

v  Evaluation of trauma or surgical complications of the bile duct or pancreatic duct

v  Treatment of stenosis of the main bile duct

v  Evaluation of cancers of the bile duct or pancreatic duct

v  Evaluation of complications of chronic pancreatitis

v  Hydatid cyst

v  Evaluation and treatment of sphincter dysfunction of Oddi

How should I prepare for ERCP?

Eight hours of fasting is required before the procedure. Therefore, you should not eat or drink anything for the previous 8 hours during the procedure. You should follow a special diet for 1-2 days before the procedure.

You should share the medications you use, your previous illnesses, the presence/suspect of pregnancy with your doctor before the procedure. Since some drugs cause bleeding disorders, it may be necessary to discontinue or change the drug before the procedure. Also, share this with your doctor, especially if you have a known allergy to drugs.

Since sedation will be applied during the procedure, it will be beneficial to have a relative with you to take care of you and accompany you home after the procedure.

How is ERCP done?

The ERCP procedure is done in the hospital. A sedative drug is given to you to relax and to avoid problems during the procedure by opening a vascular access in your arm. In addition, anesthetic agent is given in the form of mouthwash or spray to reduce the feeling of pain in the throat. A tube called an endoscope with a camera at the end reaches from the throat to the esophagus and from there to the stomach. Then the duodenum is reached. Sometimes air may be given through the endoscope to clarify the image. The images seen in the endoscope are simultaneously transferred to the external monitor and viewed.

During ERCP, the physician performing the procedure locates the sphincter of Oddi, the common bile duct and the main pancreatic duct with the help of an endoscope. With the help of a thin catheter sent through the endoscope, a harmless dye is given to visualize the channels. In this way, it can be understood whether there is a pathology in the channels. In addition, during this procedure, narrowed channels can be enlarged, stones causing obstruction in the channels can be removed, biopsy can be taken in suspicious cases and stent can be placed in narrowed channels.

The procedure takes approximately 1 hour.

What happens after the ERCP procedure?

After the procedure, you will rest for 1-2 hours in the hospital. In this period, the effects of sedation and anesthesia will pass. You may experience bloating and nausea during this period. You may feel a sore throat for a day or two. Once the swallowing sensation returns to normal, it is okay to eat and drink something. It will be beneficial for you to rest at home for a few days.

What are the risks of ERCP?

Although rare, some complications may develop during and after ERCP. In this case, you may need to be followed up in the hospital. These complications are;

v  Pancreatitis

v  Infection

v  Bleeding

v Perforation

 

We are at your service with our experienced gastroenterology and anesthesiologists and auxiliary staff.

Just be healthy.