ERCP is short for endoscopic retrograde cholangiopancreatography. It is a procedure that looks at the bile ducts. It is done through an endoscope.
Endoscopic retrograde cholangiopancreatography
An intravenous (IV) line is placed in your arm. You will lie on your stomach or on your left side for the test.
After the sedative takes effect, the endoscope is inserted through the mouth. It goes through the esophagus (food pipe) and stomach until it reaches the duodenum (the part of the small intestine that is closest to the stomach).
A thin tube (catheter) is passed through the endoscope and inserted into the tubes (ducts) that lead to the pancreas and gallbladder. A special dye is injected into these ducts, and x-rays are taken. This helps the doctor see stones, tumors, and any areas that have become narrowed.
Special instruments can be placed through the endoscope and into the ducts.
The procedure is used mostly to treat or diagnose problems of the pancreas or bile ducts that can cause abdominal pain (most often in the right upper or middle stomach area) and yellowing of the skin and eyes (jaundice).
ERCP may be used to:
Note: Imaging tests generally will be done to diagnose the cause of symptoms before an ERCP is done. These include ultrasound tests, CT scan, or MRI scan.
Risks of the procedure include:
You will need to not eat or drink for at least 4 hours before the test. You will sign a consent form.
Remove all jewelry so that it will not interfere with the x-ray.
Tell your health care provider if you have allergies to iodine or you have had reactions to other dyes used to take x-rays.
You will need to arrange a ride home after the procedure.
Someone will need to drive you home from the hospital.
The air that is used to inflate the stomach and bowel during an ERCP can cause some bloating or gas for about 24 hours. After the procedure, you may have a sore throat for the first day. Soreness may last for up to 3 to 4 days.
Do only light activity on the first day after the procedure. Avoid heavy lifting for the first 48 hours.
You can treat pain with acetaminophen (Tylenol). DO NOT take aspirin, ibuprofen, or naproxen. Putting a heating pad on your belly may relieve pain and bloating.
The provider will tell you what to eat. Most often, you will want to drink fluids and eat only a light meal on the day after the procedure.
Call your provider if you have:
Dageforde LA, Lillemoe KD. Management of acute cholangitis. In: Cameron AM, Cameron JL, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:457-462.
James TW, Baron TH. Endoscopic and radiologic treatment of biliary disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 70.
Lidofsky SD. Jaundice. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 21.
Reviewed By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.