Type of Surgery
Information
Last updated: 02/17/2009
ERCP is performed with the patient given either a sedative or general anesthesia. The physician then sprays the back of the patient's throat with a local anesthetic. The endoscope (a thin, hollow tube attached to a viewing screen) is then inserted into the mouth. It is threaded down the esophagus, through the stomach, and into the duodenum (upper part of the small intestine) until it reaches the spot where the bile and pancreatic ducts empty into the duodenum. At this point a small tube called a cannula is inserted through the endoscope and used to inject a contrast dye into the ducts. The term "retrograde" in the name of the procedure refers to the backward direction of the dye as it is injected through the ducts. A series of x rays are then taken as the dye moves through the ducts.
If the x rays show that a problem exists, ERCP may be used as a therapeutic tool. Special instruments can be inserted into the endoscope to remove gallstones, take samples of tissue for further examination (e.g., in the case of suspected cancer), or place a special tube called a stent into a duct to relieve an obstruction.
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Other Information
Endoscopic retrograde cholangiopancreatography (en-doh-SKAH-pik REH-troh-grayd koh-LAN-jee-oh-PANG-kree-uh-TAH-gruh-fee) (ERCP) enables the physician to diagnose problems in the liver, gallbladder, bile ducts, and pancreas. The liver is a large organ that, among other things, makes a liquid called bile that helps with digestion. The gallbladder is a small, pear-shaped organ that stores bile until it is needed for digestion. The bile ducts are tubes that carry bile from the liver to the gallbladder and small intestine. These ducts are sometimes called the biliary tree. The pancreas is a large gland that produces chemicals that help with digestion and hormones such as insulin.
ERCP is used primarily to diagnose and treat conditions of the bile ducts, including gallstones, inflammatory strictures (scars), leaks (from trauma and surgery), and cancer. ERCP combines the use of x rays and an endoscope, which is a long, flexible, lighted tube. Through the endoscope, the physician can see the inside of the stomach and duodenum, and inject dyes into the ducts in the biliary tree and pancreas so they can be seen on x rays.
For the procedure, you will lie on your left side on an examining table in an x-ray room. You will be given medication to help numb the back of your throat and a sedative to help you relax during the exam. You will swallow the endoscope, and the physician will then guide the scope through your esophagus, stomach, and duodenum until it reaches the spot where the ducts of the biliary tree and pancreas open into the duodenum. At this time, you will be turned to lie flat on your stomach, and the physician will pass a small plastic tube through the scope. Through the tube, the physician will inject a dye into the ducts to make them show up clearly on x rays. X rays are taken as soon as the dye is injected.
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