Duke’s nationally recognized experts offer particular
expertise in endoscopic retrograde cholangiopancreatography
(ERCP), which is used to provide the most accurate diagnosis
for patients who may have problems in the liver, gallbladder,
bile ducts, or pancreas. Duke performs a large volume of these
procedures each year.
The procedure combines the use of x-rays and an endoscope,
which is a long, flexible, lighted tube. Through it, the
physician can see the inside of the stomach and duodenum, and
from there inject dyes into the ducts of the biliary tree and
pancreas so they are visible on x-rays.
ERCP is used primarily to diagnose and treat conditions of
the bile ducts including gallstones, inflammatory strictures
(scars), leaks (from trauma and surgery), and cancer.
The full name, endoscopic retrograde
cholangiopancreatography, is pronounced en-doh-SKAH-pik
REH-troh-grayd koh-LAN-jee-oh-PANG-kree-uh-TAH-gruh-fee.
During the Procedure
The patient will lie on his or her left side on an examining
table in an x-ray room. The patient will be given medication to
help numb the back of their throat and a sedative to help them
relax during the exam. He or she will then swallow the
endoscope, and the physician will guide the scope through their
esophagus, stomach, and duodenum until it reaches the spot
where the ducts of the biliary tree and pancreas open into the
duodenum.
At this time, the patient will be turned to lie flat on
their stomach, and the physician will pass a small plastic tube
through the scope. Through the tube, the physician will inject
a dye into the ducts to illuminate them on the x-rays. X-rays
are taken as soon as the dye is injected.
If the exam shows a gallstone or narrowing of the ducts, the
physician can insert instruments into the scope to remove or
relieve the obstruction. Also, tissue samples (biopsy) can be
taken for further testing.
Possible complications of ERCP include pancreatitis
(inflammation of the pancreas), infection, bleeding, and
perforation of the duodenum. Except for pancreatitis, such
problems are uncommon. The patient may have tenderness or a
lump where the sedative was injected, but that should go away
in a few days.
The ERCP procedure can take from 30 minutes to two hours to
complete. The patient may have some discomfort when the
physician blows air into the duodenum and injects the dye into
the ducts. However, the pain medicine and sedative should
minimize the discomfort.
After the procedure, the patient will need to stay at the
hospital for one to two hours until the sedative wears off. The
physician will make sure the patient does not have any signs of
complication before they leave. If any kind of treatment is
done during ERCP, such as the removal of a gallstone, the
patient may need to stay in the hospital overnight.
Physicians
Physicians offering this service include:
Locations
This service is available at:
