Endoscopic retrograde cholangiopancreatography: Abbreviated ERCP. A procedure done to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas, including gallstones, inflammatory strictures (scars), leaks (from trauma and surgery), and cancer. ERCP combines the use of x-rays and an endoscope (a long, flexible, lighted tube). Through it, the physician can see the inside of the stomach and duodenum and inject dye into the bile ducts and pancreas so they can be seen on x-ray. ERCP takes 30 minutes to 2 hours. Possible complications of ERCP include pancreatitis (inflammation of the pancreas), infection, bleeding, and perforation of the duodenum.

For the procedure, the patient lies on the left side on an examining table in an x-ray room. Medication is given to help numb the back of the throat and a sedative is usually given to help relax during the exam. The patient swallows the endoscope, and the physician then guides the scope through the esophagus, stomach, and duodenum until it reaches the spot where the ducts of the biliary tree and pancreas open into the duodenum. At this time, the patient is turned to lie flat on their stomach, and the physician passes a small plastic tube through the scope. Through the tube, the physician will inject a dye into the ducts to make them show up clearly on x-rays. X-rays are taken as soon as the dye is injected.

If the exam shows a gallstone or narrowing of the ducts, the physician can insert instruments into the scope to remove or relieve the obstruction. Also, tissue samples (biopsy) can be taken for further testing.

There may be some discomfort when the physician blows air into the duodenum and injects the dye into the ducts. After the procedure, the patient needs to stay at the hospital for 1 to 2 hours until the sedative wears off. If any kind of treatment is done during ERCP, such as removing a gallstone, the patient may need to stay in the hospital overnight.

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