Endoscopic Retrograde Cholangiopancreatography (ERCP)
ERCP is a study of the ducts that drain the liver and pancreas. A diagnostic ERCP is when X-ray contrast dye is injected into either the bile duct or pancreatic duct and then X-rays are taken during the ERCP to get pictures of these ducts. However, most ERCPs are actually done for treatment and not just picture taking. When an ERCP is done to allow treatment, it is called therapeutic ERCP.
There are several treatments that can be done through an ERCP scope. The most common treatment is the removal of bile duct stones. These stones may have formed in the gallbladder and traveled into the bile duct or may form in the duct itself years after your gallbladder has been removed. After a sphincterotomy is performed, the stones can be pulled from the duct into the bowel.
A sphincterotomy is a cutting of the muscle that surrounds the opening of the ducts. The cut is made to enlarge the opening. A small wire on a specialized catheter uses electric current to cut the tissue. This does not cause discomfort as you do not have nerve endings there. This small cut allows various treatments in the ducts.
Tissue sampling is also commonly performed through an ERCP scope. There are several different sampling techniques although the most common is to brush the area with a subsequent examination of the cells obtained. Tissue samples can help decide if a narrowing is due to cancer.
Stent placement is another treatment. Stents are placed into the bile or pancreatic ducts to bypass narrowed parts of the duct which are due to scar tissues or tumors that cause blockage of normal duct drainage.
Balloon dilation is a catheter fitted with a dilating balloon that can be placed across a narrowed area. The balloon is then inflated to stretch out the narrowing. Dilation with balloons is often performed when the cause of the narrowing is benign (not a cancer). After balloon dilation, a temporary stent may be placed for a few months to help maintain the dilation.
The preparation for the procedure is nothing to eat or drink for a least 6 hours before your procedure time. You will be given medication to relax you during the procedure. The procedure is performed on an X-ray table.
After the ERCP is complete you will go to a recovery area until the sedation effects subside. You can then return to full activity the following day.