Endoscopic Retrograde Cholangiopancreatogram (ERCP)

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What Is ERCP?

The ERCP procedure is a specialized use of the endoscope to examine and treat the drainage systems, or ducts, of the pancreas, liver and gallbladder.

It is performed while you are under sedation, and you’ll likely go home the same day as your procedure.

The ERCP procedure is helpful for diagnosing and treating the many conditions that affect the pancreas, liver and gallbladder and their drainage systems, including:

  • Gallstones that can become trapped in the bile duct
  • Blockage of the bile ducts, which can cause pain and jaundice
  • Abdominal pain
  • Cancer of the pancreas or bile ducts
  • Pancreatitis (inflammation, acute or chronic, of the pancreas)

The ERCP procedure requires skill and experience. Board-certified and fellowship-trained gastroenterologists at Norton Healthcare Gastroenterology have been performing the procedure in Louisville and Southern Indiana for years.

ERCP can be used with therapeutic endoscopic ultrasound (EUS) to effectively manage pancreatic biliary disorders nonsurgically. Depending on the findings of the ERCP, your physician may need to cut the duodenal papilla to help remove stones, place stents or improve drainage of bile or pancreatic fluid.

What Is Involved in an ERCP Procedure?

During an ERCP procedure, a specialized endoscope (a thin, flexible tube that allows the doctor to see inside the gastrointestinal tract) is passed through the patient’s mouth, through the stomach and into the duodenum, the first part of the small intestine.

At the major duodenal papilla, a part of the intestine which collects drainage from the common bile duct and pancreatic duct, a catheter delivers dye that provides high contrast on X-rays of the ducts.

Preparing for the ERCP Procedure

Your physician will provide you with instructions you will need to follow in the days before your procedure. Following these instructions is essential to limit surgery risks and provide the best results.

Make sure your providers are aware of all medications that you are taking, especially the following:

  • Plavix (clopidogrel)
  • Effient (prasugrel)
  • Brilinta (ticagrelor)
  • Ticlid (ticlopidine)
  • Coumadin (warfarin)
  • Eliquis (apixaban)
  • Aggrenox (aspirin/dipyridamole)
  • Pradaxa (dabigatran)
  • Persantine (dipyridamole)
  • Xarelto (rivaroxaban)

We will advise you to discontinue or adjust your dosage of these medications. We may have you consult with your primary care physician or cardiologist prior to your procedure. Also let us know of allergies that you have to any medications.

If you are using insulin, the dosage or timing will also need to be adjusted the day of the procedure.

Refrain from eating anything starting the midnight before your procedure is scheduled.

What Happens During an ERCP Procedure?

Typically, patients go home the same day as an ERCP procedure. The ERCP procedure is performed with you lying prone (face down) and typically takes 30 to 40 minutes to complete.

You may be given antibiotics during and after the procedure to prevent infection. A suppository medication may be administered while you are sedated to prevent pancreatitis after the ERCP.

After you recover from sedation, your physician will give you a preliminary report of the procedure. Final results of biopsies will be available in several days.

Due to the effects of sedation, patients are instructed not to drive, operate machinery or make important decisions for the 24 hours following ERCP. You will need to arrange for someone to drive you home. Some patients may have a temporary sore throat after the procedure; over-the-counter anesthetic lozenges can soothe symptoms.

You will be able to eat after you leave the hospital, unless instructed otherwise. Start with clear liquids, then bland foods before adopting a special diet. The nursing staff will review these and other important instructions before you go home.

Call your physician if you get a fever, have trouble swallowing or have pain in the throat, chest or abdomen.

If you are unable to keep your appointment or need to reschedule, call our office at (502) 896-4711 at least 48 hours prior to your procedure.

If you are going to be late for your procedure, call the hospital’s endoscopy department. If you are scheduled at Norton Women’s & Children’s Hospital, call (502) 893-1277. If you are scheduled at Norton Brownsboro Hospital, call (502) 446-8200.

About Norton Healthcare Gastroenterology

  • Norton Cancer Institute has nine outpatient locations and multiple infusion centers in Louisville and surrounding counties and Southern Indiana. We have three radiation centers located just off major interstates, with free, self-service parking and valet parking.
  • Our gastrointestinal cancer patient navigator guides you through the treatment process. The navigator is a registered nurse and advocate for patients and families who can help coordinate scheduling to minimize your visits. The navigator provides information and support throughout your diagnosis, treatment and beyond.
  • The Norton Cancer Institute multidisciplinary approach to cancer care means you’ll have access to multiple specialists, including medical oncologists, radiation oncologists, surgical oncologists, interventional radiologists, interventional gastroenterologists, researchers, geneticists and dietitians.
  • We pull together providers from various disciplines to help identify the best treatment for you. At Norton Cancer Institute review boards, you will be considered for innovative clinical trials, immunotherapy, minimally invasive procedures, state-of-the-art radiation and advanced diagnostics.

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