An endoscopic retrograde cholangiopancreatogram (ERCP) test checks the tubes (ducts) that drain the liver, gallbladder, and pancreas. A flexible, lighted scope (endoscope) and X-ray pictures are used.
The scope is put through the mouth and gently moved down the throat. It goes into your esophagus, stomach, and duodenum until it reaches the point where the ducts from the pancreas and gallbladder drain into the duodenum. X-rays will then be taken.
ERCP can treat certain problems found during the test. In some cases, your doctor can insert small tools through the scope to:
ERCP is done to:
Follow the instructions exactly about when to stop eating and drinking, or your test may be canceled. If your doctor told you to take your medicines on the day of the test, do so using only a sip of water.
If your doctor prescribed antibiotics before the test, take them as directed. You need to take the full course of antibiotics.
Tell your doctor if you:
Talk to your doctor about any concerns you have about the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form (What is a PDF document?).
You will be asked to empty your bladder. You will also need to remove any dentures, jewelry, or contact lenses before you have this test.
An endoscopic retrograde cholangiopancreatogram (ERCP) is usually done by a gastroenterologist. This is a doctor who has special training in diseases of the digestive system. The doctor must be trained in endoscopy. A thin, flexible fiber-optic endoscope (scope) is used.
This test is done in the hospital. You may have to stay overnight if your doctor takes out gallstones or places a stent during the test. Otherwise, you can go home after the test.
An ERCP usually takes 30 to 60 minutes. You will be in the recovery room 1 to 2 hours.
Your throat may be numbed with an anesthetic spray, gargle, or lozenge to relax your gag reflex. This makes it easier to insert the scope. Shortly before the test begins, an intravenous (IV) line will be placed in a vein in your arm. You will get pain medicine and a sedative through the IV during the test. You may also get an antibiotic through the IV.
You will need to lie on your left side. Your head will be tilted slightly forward. A mouth guard may be inserted to protect your teeth from the scope. The scope's tip will be lubricated. The doctor will guide it into your mouth while gently pressing your tongue out of the way. You may be asked to swallow to help move the tube along. The scope is no thicker than many foods you swallow.
When the scope is in your esophagus, your head will be tilted upright to help the scope slide down. Then your doctor will slowly move the scope into your stomach and duodenum. Your doctor looks at all three of these areas as the scope moves forward. When it reaches your duodenum, you will be turned over to lie flat on your belly.
A small amount of air will be injected through the scope. This makes it easier for the doctor to see. The doctor will move the scope forward until it reaches the point where the ducts from the pancreas and gallbladder drain into the duodenum. A thin tube called a catheter is then passed through the scope into that area. Then contrast material is injected into the bile or pancreatic ducts. Several X-rays are taken. You will stay on your belly until the X-rays are ready to view. If needed, the doctor may take more X-rays.
The doctor may insert small tools through the scope. This allows the doctor to take a tissue sample, remove a gallstone, open a narrowed bile duct, or place a stent.
When the test is done, the scope is slowly withdrawn.
After the test, you will be observed in a recovery room. If your throat was numbed before the test, you will not be allowed to eat or drink until your throat is no longer numb. You will need to be able to swallow without choking. You can then eat and drink normally.
If your doctor removed a gallstone or placed a stent during the test, you may need to stay a night in the hospital. You cannot drive or return to work for 24 hours. If you can go home the day of the test, you will need to have someone drive you.
Your doctor will check for signs of problems before you go home.
After the test, you may feel bloated and notice a temporary change in your bowel habits. This is because air was used to open the bile and pancreatic ducts. Call your doctor if you have bleeding from the rectum or if your stools look black or bloody.
You may notice a brief, sharp burning or stinging when the IV is started in your arm. The local anesthetic sprayed into your throat usually tastes slightly bitter. It will make your tongue and throat feel numb and swollen. Some people report feeling as though they cannot breathe sometimes because of the tube in their throat. This is a false sensation caused by the anesthetic. There is always plenty of breathing space around the tube in your mouth and throat. Remember to relax and take slow, deep breaths.
You may gag, feel nauseated or bloated, or have mild belly cramps as the tube is moved. If the discomfort is severe, alert your doctor with an agreed-upon signal or tap on the arm. Even though you won't be able to talk during the test, you can still communicate.
The IV medicines will make you feel sleepy. You may not be able to remember much of what happens during or for several hours after the test. You may have heavy eyelids, trouble speaking, a dry mouth, or blurred vision for several hours after the test.
You may feel flushed when the contrast material is injected.
After the test, you may have gas and feel bloated for a while. You may also have a dry and tickling throat, slight hoarseness, or a mild sore throat for several days. Using throat lozenges and gargling with warm salt water can help relieve your throat symptoms.
Because of the IV medicines used during this test, do not drink alcohol, drive, or sign any legal documents for 24 hours after the test.
Complications are not common. But having this test may cause serious problems, such as:
After the test, call your doctor right away if you:
People who have serious heart disease and older adults who have other chronic diseases have a greater chance of having problems from this test. Talk to your doctor about your specific risks.
Your doctor may be able to tell you about some findings right after the test. But the medicines used to relax you for the test may impair your memory. So your doctor may tell you to call the next day for your results.
You may not be able to have the test, or the results may not be helpful, if:
Other Works Consulted
- Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis: Saunders.
- Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
- Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Jerome B. Simon, MD, FRCPC, FACP - Gastroenterology
Current as ofJune 24, 2014
Current as of: June 24, 2014
Author: Healthwise Staff
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