Eisenhower Army Medical Center
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Endoscopic Retrograde Cholangiopancreatography (ERCP)

After careful medical assessment, your doctor has recommended that you have an ERCP. ERCP is a valuable test for many of the disease of the pancreas, liver, bile ducts, and gall bladder. The ERCP allows the doctor to perform necessary treatments such as enlarging a bile duct opening, removing gallstones lodged in the bile duct, inserting a stent (drain) in the duct, or taking a biopsy specimen (small piece of tissue).

During this procedure a flexible fiberoptic scope (endoscope) is passed through the mouth and throat and past the stomach into the first part of the small intestines known as the duodenum. There the ampulla (the opening where the bile and pancreatic ducts empty their digestive fluids into the duodenum) is identified. A small plastic tube (catheter) is passed through the scope into the ampulla. X-ray dye is injected through the cannula into the ducts. X-rays may then be taken so as to examine the ducts. Any necessary treatments may be performed at this time.

You will be asked to sign a consent form authorizing the doctor to perform the procedure. Please let the doctor and GI nurse know if you are allergic to any medications, x-ray dyes, or iodine. An IV will be placed in your arm vein prior to the procedure. Medicine will be injected through this needle to make you sleepy and relaxed. Your throat will also be sprayed with a numbing medicine. As you lay on your left side the nurse will place a small mouthpiece between your teeth. You will be able to breath normally.

The doctor will then place a flexible endoscope through your throat, down into your duodenum. Once the scope is present in the duodenum you will be helped to turn onto your abdomen with your head turned to the right. During the procedure you may feel some abdominal fullness or bloating due to the air which the doctor puts into the duodenum. As the x-ray dye is injected into the ducts, you may feel some mild discomfort. These feelings should be completely tolerable and not painful. After the scope is removed you may be asked to move into various positions so that more x-rays can be taken.

Many people do not recall any of the procedure because of the effect of the medicine. After the procedure you may feel drowsy and may sleep for a short time. The doctor will provide you with written report and instructions when you go home. Please feel free to ask the doctor or GI nurse or technician any questions you may have.