ERCP – Endoscopic retrograde cholangiopancreaticography

Procedure

An infusion is first placed in the arm to administer sedatives and sleeping medication. During the examination, a specially trained nurse (nurse practitioner or practice assistant) is present in addition to the doctor. The examination does not usually cause any pain. A thin, movable “tube” with a light source and a camera attached to its tip is used for the examination. This allows the doctor to see through the mouth, esophagus, stomach and duodenum to the mouth of the bile ducts and pancreatic duct. A contrast agent is then injected into the bile ducts and x-rayed. If pathological changes are detected, treatment is carried out during the examination.

Additional intervention options

The following procedures and treatments are carried out depending on the findings:

• Removal of gallstones
• Dilation of constrictions in the bile duct or pancreatic duct
• Insertion of a tube to bridge constrictions
• Drainage of bile or pancreatic secretions.

These treatments may require a papillotomy, i.e. a division of the sphincter muscle at the end of the bile duct where it opens into the small intestine. An electric cutter is used for this purpose, which is inserted through the endoscope. In some cases, it can only be decided during the examination which additional interventions are necessary. In these cases, we must decide in your best interests without being able to discuss this in detail beforehand.

Preparation

Please do not eat any solid food from midnight before the ERCP, as the upper digestive tract must be free of food residues for the examination. Drinking clear, fat-free liquids (no milk) is permitted up to two hours before entry. Do not take your regular medication unless your doctor specifically advises you to do so.

Aftercare

As you have been given sedative/pain-relieving medication, you will be monitored for one to two hours after the examination. If you experience abdominal pain or other symptoms (e.g. dizziness, nausea, vomiting, fever) after the ERCP or if blood comes out of the anus (usually in the form of black, thin stool), go to the emergency ward or inform your doctor immediately.