Best hospital in Delhi, India: FAQs on Endoscopic retrograde cholangiopancreatography ( ERCP)

ERCP is a technique used to study the ducts (drainage routes) of the gallbladder, pancreas,

and liver (the drainage channels from the liver are called bile ducts). An endoscope

(flexible thin tube that allows the doctor to see inside the bowel) is passed through

the mouth, oesophagus, and stomach into the duodenum (first part of the small intestine).

After the common opening to ducts from the liver and pancreas is visually identified, a

catheter (narrow plastic tube) is passed through the endoscope into the ducts. Contrast

material ("dye") is then injected gently into the ducts (pancreatic or biliary) and x-ray

films are taken. ERCP may be useful in diagnosing and treating problems causing jaundice

(yellowing of the whites of the eyes) or pain in the abdomen, for example, blockage

of the bile ducts by gallstones, tumours or scarring.

It is necessary to have a completely empty stomach. You should therefore fast for
at least 6 hours before the procedure.
If you are allergic to iodine- containing drugs (contrast material or "dye") you should
discuss this with your doctor prior to the procedure.
The doctor performing the procedure should be informed of any medications that you
take regularly, any heart or lung conditions (or any other major diseases), and whether
you are allergic to any medications.
Someone must accompany you home from the procedure because of the sedation
used during the examination. Even if you feel alert after the procedure, your judgement
and reflexes may be impaired by the sedation for the rest of the day, making it unsafe for
you to drive or operate any machinery. If a complication occurs, you may need to stay in
hospital until it resolves.

An intravenous sedative will be given to make you more comfortable during the test.

Some patients also receive antibiotics before the procedure. The endoscope

is passed through the mouth, oesophagus, and stomach into the duodenum.

The instrument does not interfere with breathing.

Localised irritation of the vein into which medications were given may rarely cause
a tender lump that may last several days.
Major complications requiring hospitalisation can occur but are uncommon during
diagnostic ERCP. They include serious inflammation of the pancreas ('pancreatitis') and
even more rarely infections, bowel perforation, and bleeding. Another potential risk of
ERCP is an adverse reaction to the sedative used. The risks of the procedure vary with the
reasons for the test, what is found during the procedure, whether any therapy is undertaken,
and the presence of other major medical problems, e.g., heart or lung diseases. Your doctor
will tell you what is your likelihood of complications before undergoing the test.
If therapeutic ERCP is performed (cutting an opening in the bile duct, stone removal,
dilation of a stricture (narrowing), stent or drain placement, etc), the possibility of
complications is higher than with diagnostic ERCP; complications include pancreatitis,
bleeding, and bowel perforation. These risks must be balanced against the potential
benefits of the procedure and the risks of alternative surgical treatment of the condition.
Often these complications can be managed without surgery, but occasionally they do require
corrective surgery.

If you are having ERCP as an outpatient, you will be kept under observation until most

of the effects of the medications have worn off. Evidence of any complications of the

procedure will be looked for and hospitalization may be advised if further

observation is necessary. You may experience bloating or pass gas because of the

air introduced during the examination. You may resume your usual diet unless you are

instructed otherwise.

Best hospital in Delhi, India