Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure that combines upper gastrointestinal (GI) endoscopy and x-rays to examine the bile ducts and the pancreatic ducts. These tube-like structures drain fluid from the liver and pancreas into the gut.

The bile ducts carry bile, which is used for the absorption of fats, from your liver to your gallbladder and duodenum. The pancreatic ducts carry pancreatic juices, which aid in the digestion of proteins, carbohydrates, and fats, from the pancreas to the duodenum. The liver and pancreatic ducts empty into the common bile duct, which connects your liver, gallbladder, and pancreas to the small intestine.

ERCP is prescribed when your bile or pancreatic ducts have become narrowed or blocked, possibly due to:

  • Gallstones that are stuck in the common bile duct
  • Infection
  • Acute pancreatitis
  • Chronic pancreatitis
  • Trauma or surgical complications affecting the bile or pancreatic ducts
  • Pancreatic pseudocysts
  • Tumors or cancers of the bile ducts or pancreas

During ERCP, anesthesia is administered to keep you comfortable. You will be given an injection of contrast dye so that the ducts will show up on an X-ray. A flexible video endoscope is passed through the mouth and threaded through the duodenum. A catheter is then passed through the scope and into the bile duct and/or pancreatic duct.

ERCP is recommended as a less invasive alternative to surgery when the bile ducts are blocked or thought to contain gallstones. If ERCP is being performed therapeutically, a cut (sphincterotomy) may be made where the bile duct enters the duodenum, allowing for stones to be removed minimally invasively using special tools. Plastic or metal tubes called stents may also be placed in the bile duct to relieve blockages.

Preparing for Your Procedure

If you are scheduled for ERCP, plan to take the day off work. Talk to your doctor about any diet and/or medication restrictions the week before the ERCP test. Be sure to bring up any type of blood thinning medication you are taking. Avoid eating a heavy meal for at least 8 hours before the procedure. You can have a light meal or opaque liquids up to 6 hours before the procedure and clear liquids up to 2 hours before.

ERCP is performed at MarinHealth Medical Center.