ERCP (Endoscopic Retrograde Cholangiopancreatography)

Endoscopy Procedure (Digestive System)

What is the test?

ERCP is a test used to evaluate the biliary and pancreatic ducts. These tiny channels carry bile from the liver and pancreatic juice from the pancreas to the common bile duct, which connects to the top part of the small intestine. ERCP combines endoscopic and imaging technology to visualize these ducts. This exam may be used to evaluate conditions such as acute or recurring inflammation of the pancreas, unexplained abdominal pain, jaundice, bile duct disease, or to visualize the area prior to therapeutic endoscopy to remove a duct stone or place a stent.

How do I prepare?

You may consume only clear liquids after midnight on the night before a morning procedure. At three hours prior to the exam time, you should consume nothing more. (These instructions are for an early morning procedure and are modified if your exam is scheduled for late morning or afternoon.) If you are taking aspirin or blood thinners, talk with your doctor about the possible need to discontinue them prior to your ERCP.

Since you will be under mild sedation during the exam, you must bring a friend or family member with you to review the test results and discharge instructions, and to drive you home after the exam. If you are relying on taxi or bus service for transportation, you must have a companion accompany you. Sedation can also make people forgetful, so plan the rest of your day accordingly.

What can I expect during the procedure?

Plan to arrive 30 minutes prior to your procedure. Once you arrive in the Endoscopy Department, a nurse will take your health history and blood pressure, and the doctor will answer any questions you have about the procedure. You will receive an intravenous sedative to make you drowsy.

The gastroenterologist will then introduce the endoscope through your mouth and advance it slowly into the esophagus, through the stomach, and into the small intestine where the bile and pancreatic ducts enter. Through a small hollow tube passed through the endoscope the physician will inject contrast medium into the duct being examined. X-rays are then taken to identify stones, narrowings, or abnormalities. If a stone is present in the duct, the gastroenterologist can remove it at this time. Similarly, if a narrowing is identified, a stent can be placed to open it up. ERCP takes about 2 hours and you should plan to spend 4 to 6 hours at the medical center. Occasionally, patients stay over night following this procedure.

How and when will I get my test results?

After your exam, you will be moved to the recovery area of the Endoscopy Department until you are fully awake and meet certain discharge criteria. Your physician will discuss the results with you and your companion and send a report to your primary care provider. Your companion should drive you home, as it will be unsafe for you to operate a car or perform tasks that require alertness and coordination for the remainder of the day. Within 2 to 4 hours, you may eat a light meal. The day after the procedure, you may resume a full diet.

Where is the test performed?

ERCP is performed at Cayuga Medical Center at 101 Dates Drive, off NYS Route 96 in Ithaca.