What is an endoscopic retrograde cholangiopancreatogram?

Endoscopic retrograde cholangiopancreatogram (ERCP) is a test to look at the tubes that carry fluids from the liver, gallbladder, and pancreas. These tubes are called ducts.

For this test, the doctor will use a tool called an endoscope, or scope. It is a thin, lighted tube that bends. It has a camera on it that lets the doctor use pictures on a screen to guide it.

This test is used for different reasons. It can help find out the cause of your symptoms. If the test shows gallstones or a narrow spot in a bile duct, the doctor can use the scope to remove the stones or widen the duct. He or she may also put a metal or plastic tube in the duct. This can help open it.

Before the test, you may get medicine to numb the back of your throat. You also will get medicine to help you relax.

During the test, you will lie on your left side or on your stomach. The doctor puts the scope in your mouth and then gently moves it toward the back of your throat. The doctor will tell you when to swallow. This helps the scope move down your throat. You will be able to breathe normally.

After that, the doctor moves the scope through the tube (esophagus) that leads to your stomach, through your stomach, and into the first part of your small intestine. When the scope reaches the place where the bile ducts and the pancreas meet the small intestine, you may turn and lie on your stomach. The doctor then puts a small plastic tube into the scope to inject dye into the ducts. The dye helps the ducts show up on X-rays. Then the doctor takes X-ray pictures to help find any problems.

The test takes 30 to 90 minutes. You may go home the same day. But if you have treatment during the test, you may need to stay in the hospital overnight.

How do you prepare for the procedure?

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

• You may need to stop eating and drinking before the day of the procedure. If this is the case, your doctor will tell you what to do.
• 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 are allergic to any dyes, including iodine.
• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what procedure is planned, along with the risks, benefits, and other options.
• 
  Tell your doctor ALL the medicines and natural health products you take. Some may increase the risk of problems during your procedure. Your doctor will tell you if you should stop taking any of them before the procedure and how soon to do it.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Make sure your doctor and the hospital have a copy of your advance care plan. If you don't have one, you may want to prepare one. It lets others know your health care wishes. It's a good thing to have before any type of surgery or procedure.

What happens on the day of the procedure?

• 
  Follow the instructions exactly about when to stop eating and drinking. If you don't, your procedure may be cancelled. If your doctor told you to take your medicines on the day of the procedure, take them with only a sip of water.
• Take a bath or shower before you come in for your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
• Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

• 
  Bring a picture ID.
• You may get medicine that relaxes you or puts you in a light sleep. The area being worked on will be numb.
• Tell your doctor if you are allergic to iodine. It is in the dye that the doctor puts into the bile ducts.
• The doctor may send puffs of air through the tube to see better. This may make you feel bloated. You may also feel cramps. This feeling does not last long.
• You may feel some bloating or cramping as the tube is moved. If you are very uncomfortable, you can let the doctor know with a signal or a tap on the arm. You and your doctor can agree on this signal before the test.
• After, you will stay at the hospital or clinic for 1 to 2 hours until the medicine wears off.