Endoscopic retrograde cholangio-pancreatogram (E.R.C.P.)

This is a test that allows your doctor to examine your pancreas and bile duct and take an X-ray picture.  You will need to go into hospital for an ERCP.  The actual test will take place in the X-ray department or endoscopy suite.

Your doctor can use the information from the ERCP to diagnose and treat blockages that cause jaundice (yellowing of the whites of the eyes and skin).

Preparation

The day before your ERCP, you may need to attend a pre-admission clinic so that some blood can be taken for tests. You will need to tell the staff if you suffer from diabetes or glaucoma or take Warfarin.

You must have nothing to eat or drink for at least 6 hours before your test.

What happens?

When you go into hospital, the doctor will put a small needle into the back of your right hand so that you can have some sedation.

You will then need to lie on your left-hand side with your left arm behind your back. The nurse who is looking after you will place a clip on your finger that monitors your pulse rate and oxygen levels.  You may also be given some oxygen through a mask.

An ERCP X-Ray
An ERCP X-Ray

The doctor will pass the endoscope tube down your oesophagus into your stomach.  The tube then passes into the first part of your small bowel (the duodenum), where the opening to the ducts leading to the liver and pancreas are.  The doctor then passes a narrow plastic tube, called a catheter, down through the endoscope and into this opening.

He/she will then inject an X-ray dye through the catheter so that the bile ducts and the pancreas can be seen clearly on X-ray. The dye used is harmless and will pass out of your body naturally.  If the doctor sees a narrowing, he/she can put a small plastic tube, called a stent, into the bile duct to drain the bile in to the duodenum and relieve the blockage.  If the bile has not been able to drain properly, you may be jaundiced

If the doctor sees any abnormalities, he/she will take a biopsy.  Cell samples, called “brushings”, can also be taken from inside the small ducts.   The biopsies and/or cell samples will be sent to the pathology department and examined closely under a microscope. It will take several days before the results are known.  The doctor may take some photographs of the area for closer examination later.

How long does the test take?

The test can take between 25 – 30 minutes.

How will I feel after the test?

You will go back to the ward in your bed and a nurse will check your pulse and your blood pressure regularly until you are fully awake. You may feel sleepy for a couple of hours because of the sedation.

After you have been back in the ward for about 2 hours some blood  will be taken to check if there has been any irritation to your pancreas (pancreatitis) after your ERCP.  Until the result of your blood test is known, you will be not be able to eat or drink anything. You might be able to have fluids via a “drip” in your hand in the meantime. If you develop pancreatitis, you will need to stay in hospital until it settles.

You will also need to stay in hospital overnight, if you have had a stent put in.

If you are allowed home on the same day as the test, then you will need someone to look after you for the next 24 hours.  It takes this long for the sedation to leave your system and during this time you must not drive, or operate heavy machinery, make any important decisions or take any alcohol.

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Information Product No. PCA0013 v1 | Published: 03/01/2014 | Last Updated: 21/04/2015 | Next Review Due: 03/01/2017