ERCP
“Hospital without walls”
Your doctor has recommended that you have a special test called an ERCP (Endoscopic Retrograde Cholangio-Pancreatography).
This leaflet will tell you what to expect.
What is an ERCP?
An endoscopy is the term used when the doctor looks inside you by passing a tiny camera down your throat on the end of a very narrow and flexible tube called an endoscope. For ERCP, a special dye is injected into the ducts of the pancreas and the bile duct system so the doctor can see them clearly through the endoscope. Your pancreas and bile ducts are important parts of your digestive system.
How can I prepare for my ERCP?
You will probably have to spend at least 1 night in hospital (up to 3 days is normal). The procedure must be performed on an empty stomach, so you shouldn’t eat or drink anything for at least 6 hours beforehand. Before the procedure, a doctor will explain to you what is going to happen, and you will be asked to sign a consent form to show that you have understood what they are going to do. You should tell a nurse or doctor if you have any allergies or if you have had a bad reaction to other tests or to any drugs, or if you have had an endoscopy before. This is also a good time to mention any worries or questions, so that you can relax before the procedure. You might be given an injection of antibiotics before the procedure, although this is not always necessary. You might be asked to undress and put on a hospital gown, and you will have to remove false teeth, contact lenses, and jewellery, because metal objects interfere with X-rays.
What will happen during my operation?
You will lie on an X-ray table, and will have a local anaesthetic sprayed on the back of your throat to numb it. A soft tube will be placed into one of your nostrils to help you breathe during the test. You will have a drip in your arm and will be given an injection through this to make you sleepy. When this sedative has taken effect, the doctor will pass the endoscope down your throat into your stomach and the top part of your small intestine. Special dye will be put down the endoscope so that your pancreas and bile ducts will show up on the X-ray. The dye is harmless and your body will get rid of it naturally. If everything is normal, the test is over and the endoscope will be removed.
If the X-rays show any gallstones (insert definition of ‘gallstones’ here), the doctor will enlarge the opening of your bile duct using an instrument called a diathermy. You won’t be able to feel this. The stones will be collected into a very small basket or will be able to leave your body naturally via your intestines.
If the X-rays show that your bile duct is too narrow, a small plastic tube called a stent will be left in the narrow place to hold it open and to let the bile drain away normally. It will remain there permanently, but you won’t be able to feel it. If it gets blocked, which doesn’t usually happen, it will have to be replaced.
What will happen after the procedure?
You will feel sleepy from the sedative and will return to your ward, under the care of nursing staff. You will be told the results of the ERCP and the treatment you have had will be explained to you. The nurses will tell you when you can eat and drink. If your throat has been numbed for the endoscopy, you won’t be able to swallow right away and will have to wait for the anaesthetic to wear off (this takes 1-2 hours). You can then eat and drink normally, although your throat may feel a bit sore.
If you are not having any other treatment at the same time as your ERCP, you might be able to go home on the same day. If so, you must arrange for someone to collect you and drive you home. The sedative will stay in your system for a while so you should rest for the rest of the day, and you should not drive, operate machinery or drink alcohol. Check with the doctors whether they have given you anything that will affect your ability to do these things. You should be able to resume normal activities on the day after the procedure.
When you leave the hospital, you might be given an envelope, which you should give to your GP as soon as possible. It contains a written report of your stay in hospital. Feel free to look at this report - it contains the same information that you will have been given after your ERCP.
Are there any possible problems?
ERCP is a very safe way of curing health problems like yours. Complications can occur, but this is very rare. If there are complications with your ERCP, you will have to stay in hospital for longer while you recover. Ask your doctor or the hospital staff if you would like to know more about possible risks or complications of ERCP, or if you feel worried or unsure about anything.