ERCP

Procedure
During an ERCP, your doctor will pass an endoscope through your mouth, esophagus and stomach into the duodenum (first part of the small intestine). An endoscope is a thin, flexible tube that lets the doctors see inside your bowels. After the common opening to ducts from the liver and pancreas can be seen, a narrow plastic tube called a catheter will be passed through the endoscope and into the ducts. A contrast material (dye) will then be injected into the pancreatic or biliary ducts and x-rays taken.

Benefits
ERCP is a valuable tool that is used for diagnosing many diseases of the pancreas, bile ducts, liver, and gallbladder. ERCP can be used to determine whether or not surgery is necessary and is helpful in providing the anatomic detail the surgeon needs to plan an operation when surgery is necessary.

Risks
Major complications requiring hospitalization can occur, but are uncommon during an ERCP. They can include pancreatitis (an inflammation or infection of the pancreas), infections, bowel perforation and bleeding. Some patients can have an adverse reaction to the sedative used. Complications are often managed without surgery.

Alternatives
Alternative tests to an ERCP include certain types of x-rays (CAT scan, MRI) and sonography (ultrasound) to visualize the pancreas and bile ducts. In addition, dye can be injected into the bile ducts by placing a needle through the skin and into the liver. Small tubing can then be threaded into the bile ducts. Study of the blood also can provide some indirect information about the ducts and pancreas.