Endoscopic retrograde cholangiopancreatography, ERCP for short, is a procedure that examines the drainage ducts of the liver, gallbladder, and pancreas. Bile ducts carry bile from the liver to the intestine; the pancreatic duct does the same for the digestive juices of the pancreas.
ERCP combines a flexible endoscope with contrast dye and X-ray images to show these ducts clearly. What sets it apart from a scan is that your doctor can treat many problems during the same procedure, not just find them.
Why it is recommended
ERCP is used most often when a duct is blocked or narrowed. Common reasons include gallstones that have moved into the bile duct, jaundice (a yellowing of the skin or eyes), bile leaks after gallbladder surgery, narrowing caused by inflammation or a tumor, and certain problems of the pancreas.
During the procedure, the doctor can remove stones, widen the duct opening, place a small tube called a stent to keep a duct draining, or take tissue samples.
How to prepare
You will fast for several hours beforehand. Tell your care team about all of your medicines, especially blood thinners, and about any allergies, including past reactions to contrast dye. Because X-rays are used, let the team know if there is any chance you are pregnant, and arrange for someone to take you home.
During the procedure
ERCP is done with deep sedation or anesthesia, so you rest comfortably throughout. While you lie on your side or stomach, the endoscope is passed through your mouth to the point where the ducts empty into the intestine. A slender catheter is guided into the duct, contrast dye is injected, and X-ray pictures reveal any blockage; treatment follows in the same session as needed. Depending on what is done, the procedure may take from about half an hour to well over an hour.
Afterward
You will be observed while the sedation wears off. Recovery is a little longer than after a routine endoscopy, and some patients stay overnight for observation. A sore throat and some bloating are common and pass.
Because ERCP is more involved than other endoscopic exams, your doctor will go over its specific risks with you beforehand; the most important one to know about is pancreatitis, an inflammation of the pancreas. Contact your care team promptly if you develop worsening abdominal pain, fever, chills, or vomiting after you go home. Results and next steps are explained once the findings are clear.
Questions about your care?
This page is general education, not personal medical advice. Your care team is happy to talk through what it means for you.
Preparing for a procedure? See preparation instructions