(ERCP, ERCP of the Biliary and Pancreatic Ducts)
Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic procedure that allows the doctor to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas. The procedure combines X-ray and the use of an endoscope--a long, flexible, lighted tube. The scope is guided through the patient's mouth and throat, then through the esophagus, stomach, and duodenum (first part of the small intestine). The doctor can examine the inside of these organs and detect any abnormalities. A tube is then passed through the scope, and a dye is injected which will allow the internal organs to appear on an X-ray.
Other related procedures that may be used to diagnose problems of the liver, gallbladder, and pancreas include abdominal X-rays, computed tomography (CT scan) of the abdomen, CT scan of the liver and biliary tract, CT scan of the pancreas, cholecystography, gallbladder scan, liver scan, pancreas scan, abdominal ultrasound, and abdominal angiogram. Please see these procedures for more information.
The liver is the largest internal organ in the body. It is located in the upper right side of the abdomen, beneath the diaphragm, and on top of the stomach, right kidney, and intestines. Shaped like a cone, the liver is a dark reddish-brown organ.
The liver holds about one pint (13 percent) of the body's blood supply at any given moment. The liver consists of two main lobes, each made up of thousands of lobules. These lobules are connected to small ducts that connect with larger ducts to ultimately form the hepatic duct. The hepatic duct transports the bile (fluid that helps break down fats and gets rid of wastes in the body) produced by the liver cells to the gallbladder and duodenum (the first part of the small intestine).
The liver carries out many important functions, such as:
The biliary system consists of the organs and ducts (bile ducts, gallbladder, and associated structures) that are involved in the production and transportation of bile.
The pancreas is an elongated, tapered organ located across the back of the abdomen, behind the stomach. The pancreas has digestive and hormonal functions. The enzymes secreted by the exocrine tissue in the pancreas help break down carbohydrates, fats, proteins, and acids in the duodenum. The hormones secreted by the endocrine tissue in the pancreas are insulin and glucagon (which regulate the level of glucose in the blood), and somatostatin (which prevents the release of the other two hormones).
ERCP may be performed to assess the liver, gallbladder, biliary tree, and/or pancreas for the cause of unexplained abdominal pain or jaundice (yellowing of the skin and eyes due to bile pigments in the blood). ERCP may be used to obtain further diagnostic information in the presence of pancreatitis or cancer of the liver, pancreas, or bile ducts.
Blockages and/or stones in the bile ducts, fluid leakage from the bile or pancreatic ducts, obstructions or narrowing of the pancreatic ducts, or tumors may be found with ERCP.
There may be other reasons for your doctor to recommend an ERCP.
You may want to ask your doctor about the amount of radiation used during the procedure and the risks related to your particular situation. It is a good idea to keep a record of your past history of radiation exposure, such as previous scans and other types of X-rays, so that you can inform your doctor. Risks associated with radiation exposure may be related to the cumulative number of x-ray examinations and/or treatments over a long period of time.
If you are pregnant or suspect that you may be pregnant, you should notify your doctor. Radiation exposure during pregnancy may lead to birth defects.
Patients who are allergic to or sensitive to medications, contrast dyes, iodine, or latex should notify their doctor.
As with any invasive procedure, complications can occur. Some possible complications may include, but are not limited to, the following:
ERCP is contraindicated when previous gastrointestinal (GI) surgery has obstructed the ducts of the biliary tree, when esophageal diverticula (pouches) are present, or when acute pancreatitis is already present.
There may be risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.
Barium within the intestines from a recent barium procedure may interfere with an ERCP.
An ERCP may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your doctor's practices.
Generally, an ERCP follows this process:
After the procedure, you will be taken to the recovery room for observation. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room or discharged to your home. If this procedure was performed as an outpatient, you should plan to have another person drive you home.
You will not be allowed to eat or drink anything until your gag reflex has returned. You may notice some soreness of your throat and pain with swallowing for a few days. This soreness is normal.
You may resume your usual diet and activities after the procedure, unless your doctor advises you differently.
Notify your doctor to report any of the following:
Your doctor may give you additional or alternate instructions after the procedure, depending on your particular situation.
The content provided here is for informational purposes only, and was not designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your doctor. Please consult your doctor with any questions or concerns you may have regarding your condition.
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