Endoscopic retrograde cholangiopancreatography (ERCP) is a medical procedure performed to diagnose problems associated with the liver and gallbladder, as well as the bile ducts and pancreas. Pancreatitis is a medical condition characterized by inflammation of the pancreas. In general, ERCP and pancreatitis have a cause and effect relationship. That is, the connection between the two is that pancreatitis is a complication that can result from ERCP. While there are other causes of pancreatitis, in the ERCP and pancreatitis relationship, the procedure can irritate the pancreas, thereby causing the inflammation to occur.
In general, ERCP is a safe, low-risk procedure performed by an experienced and knowledgeable doctor. Still, complications can arise, the most common complication being pancreatitis. If a patient undergoes ERCP and pancreatitis occurs as a result, the condition is then treated in the hospital. Other complications include bleeding, infection and perforation of the bowel. While ERCP and pancreatitis have the most common connection over the procedure any of the other complications, serious complications resulting from ERCP are very rare.
To prepare for ERCP, the patient will need to have a clear stomach and duodenum. Since this is the case, he will not be able to eat or drink anything about six to eight hours before the procedure. The patient should also disclose any allergies to the doctor, as allergies can interfere with the procedure. For example, an allergy to iodine is important information to impart because the contrast dye used for ERCP contains iodine. Lastly, the patient should make preparations for someone to drive him home afterwards since he will still be recovering from sedation.
ERCP can take from 30 minutes to two hours to complete. During the procedure, the doctor inserts a long, flexible tube called an endoscope down the esophagus, through the stomach and into the duodenum, which is the first section of the small intestine. The endoscope will come to a stop at where the bile ducts and the pancreas open into this part of the small intestine. Then, the doctor inserts a small plastic tube into the endoscope and injects contrast dye into the area, making it more visible in an x-ray. The x-ray captures the bile ducts as well as the pancreatic ducts and the image helps the doctor to make a diagnosis.
To minimize discomfort throughout the procedure, the patient receives medication which numbs the back of the throat and a sedative to help him relax. While the doctor inserts the endoscope, the patient will lie on his side, but when the doctor injects the contrast dye, the patient will lie on his back. After ERCP, the patient will wait about one or two hours in the hospital for the sedative to wear off. Sometimes though, the doctor might treat the problem during ERCP, and in such a case, the patient might need to extend his stay in the hospital.
