ERCP

What is ERCP?

ERCP stands for Endoscopic Retrograde CholangioPancreatography and is a procedure for examining and diagnosing problems and/or conditions that may be affecting the bile ducts and the pancreas.

What is the pancreas?

The pancreas (the word is derived from the ancient Greek for 'all flesh') is an organ of the body situated in the abdomen behind the stomach which helps the body convert food into fuel. It has two main functions - the first is to produce hormones (like insulin) which regulate the amount of sugar in the blood (the endocrine function) and the second is to help in the digestion of food by producing pancreatic juices (the exocrine function).

What are bile ducts?

Bile, which helps in the digestion of food, is produced in the liver and is carried to the gallbladder and from there into the intestine. The network of these ducts is referred to as the 'biliary tree'. The medical term for anything related to bile ducts is 'cholangio'.

What conditions can affect the pancreas and bile ducts?

Blockages of the pancreatic ducts and bile ducts may be caused by gallstones, strictures (narrowing of tubes in the body, often cause by scarring), perforations in the ducts (possibly caused by trauma or by prior surgery), or cancer, either cancer of the pancreas itself (pancreatic cancer) or cancer of the bile ducts (cholangiocarcinoma).

How does ERCP work?

Using a modified type of endoscope inserted via the mouth, the gastroenterologist navigates down through the oesophagus and the stomach into the duodenum and then inserts a 'cannula' (a small plastic tube, also known as a 'catheter') into the opening of the bile duct. Special dye is injected into the duct and a special type of x-ray (called fluoroscopy) enable the gastroenterologist to see on a TV monitor if anything is blocking the ducts.

Much like a conventional endoscope, an ERCP endoscopy is able to perform some minor surgical procedures, such as gallstone removal, placement of stents (small propping devices) to keep ducts open and tissue removal for biopsies.

What is involved in an ERCP procedure?

ERCPs are carried out in the endoscopy unit. It would normally takes around 45 minutes. Patients are given an anaesthetic before the endoscope is introduced via the mouth. X-ray images are seen in real time by the gastroenterologist and also recorded for later analysis.

What preparation is needed before an ERCP?

You will need to fast (ie not eat or drink anything) for up to 4 hours before the procedure. You will also need to inform the doctors of any pre-existing medical conditions or any medications you may be taking. Your doctor will discuss with you the risks associated with the procedure .