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This is a procedure which allows clinicians to examine the tubes that drain bile from the liver into the bowel (bile duct and gall bladder) and from the pancreatic duct into the bowel. These tubes have a common opening into the duodenum called the ampulla. ERCP gives information about the bile ducts and the pancreatic ducts. An ERCP may be advised for diagnostic

(to obtain biopsies or brushing) or therapeutic purposes.

  • To treat jaundice caused by gall stones or narrowing of bile ducts
  • To remove stones from the bile ducts
  • To insert a plastic or metal stent (tube) to drain the bile

A flexible tube about the thickness of your little finger is passed
down through the mouth, down the gullet, through the stomach and into the duodenum, here the opening to the bile ducts / pancreatic ducts (ampulla) are identified. Through the endoscope the doctor will pass instruments through which dye is injected into the duct. Other instruments can be inserted to make a cut or to remove stones where required. The procedure is carried out with conjunction with x-rays.

Stent Insertion

A stent is a very small plastic or metal tube that is passed through the endoscope into the bile duct or pancreatic duct. This is used to allow the bile or pancreatic juices to flow past an obstruction to the bile ducts.


This is used to make a small cut in the ampulla
(opening) at the bottom of the bile duct. This allows a small basket
/ balloon to be inserted to grasp a stone or to facilitate the placement of a stent.

ERCP is the least invasive way to treat jaundice or removed bile duct stones which might otherwise require major abdominal surgery. The benefits therefore typically outweigh greatly the small risk of complications associated with the procedure.

As with all procedures there are some risks. Complications may require urgent treatment, may prolong your stay in hospital and can carry risks to life and health

Risks include:

  • Pancreatitis: Inflammation of the pancreas presents with abdominal pain and is the most commonly occurring complication (1 in 10 patients). Less commonly (1 in 100 patients) can be severe which may require prolonged hospitalisation or ICU admission
  • Internal Bleeding: This occurs in less than 1 in 50 people. This often resolves spontaneously and may require blood transfusions. In rare cases surgery or other procedures may be required
  • Infection: Cholangitis may occur after ERCP. This requires treatment with antibiotics
  • Perforation: Puncture of the bowel wall requiring surgery • Reaction: Adverse reaction to the X-Ray dye or medications used for the procedure

Scans such as ultrasound, CT or MRI can offer diagnostic information but do not. allow the treatment options of ERCP. Surgery is an option but generally carries more risks. There may be risks to your health of not proceeding with this procedure and these should be discussed with your doctor before you make any decision.

You may continue to take essential medication but if you are taking anticoagulants (e.g. warfarin, xarelto, plavix) you should receive/seek specific advice from the doctor when the test is being organised. If you have any concerns about your diabetes you should contact the Unit for advice before you attend for your test.

  • The scheduling of your appointment is an approximate estimate and unfortunately there can be unforeseen delays
  • A blood test will be taken to check your blood clotting is within the normal range
  • Food may be taken up to six hours prior to admission
  • Water can be taken up to two hours prior to admission
  • Bring your details of private medical insurance
  • Check with your insurance company prior to your admission to confirm your level of cover
  • Bring a list of current medication
  • Do not bring jewellery or large sums of money
  • If under 16 years you must be accompanied by your parent or guardian who is required to give written consent

You will be given an injection into a vein to make you feel relaxed and sleep but not unconscious. This is not a general anaesthetic. You may sometimes remember things about the test. Every effort will be made to keep you comfortable and safe for the duration of the test.

You will normally be given a suppository to reduce the risks of developing pancreatitis.

  • A nurse will be with you at all times
  • You will be asked to lie on your left side
  • A nurse will place a plastic mouth piece between your teeth to protect them and to prevent you from biting the scopeA monitor will be placed on your finger to assess heart rate and oxygen levels
  • The doctor will administer sedation and analgesia (pain relief)
  • A cold sticky pad may be placed on your leg to facilitate sphincterotomy if needed
  • The duodenoscope is passed through your mouth
  • You may breath normally throughout the procedure
  • Air is passed into your stomach which may make you belch a little
  • When the procedure is finished the duodenoscope is removed
  • You will return to the ward immediately following the procedure where you will be observed until the effects of the sedation have worn off
  • You will be required to fast for 4 to 6 hours but the doctor may request that you fast overnight
  • Your doctor may prescribe antibiotics and will inform you of the results usually on the day of the procedure, however, biopsies or brushing results may take up to 5 days
  • Normally you will be discharged the following day.

Seek medical attention if you develop:

  • Severe stomach or belly pain
  • Fever
  • Turning more yellow (jaundice)
  • Vomiting blood or black tarry stools

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