Endoscopic retrograde cholangiopancreatography or ‘ERCP’ is a procedure performed by a specially trained doctor to diagnose and treat certain conditions of the biliary system. Treatment of conditions using ERCP depends on the cause. For example, gallstones can be removed using a small cut to the duct to allow passage of stones, or stents can be placed in bile ducts where there is a narrowing. The indications for ERCP include treatment of bile duct stones, jaundice due to a stricture (narrowing) of the bile ducts, jaundice or stones following a cholecystectomy (gall bladder removal), management of bile leaks and cholangitis. ERCP is usually performed under conscious sedation however in some cases a general anaesthetic is used. The procedure lasts between 30 mins to over 3 hours depending on the complexity of the case. You should be fasted for at least 6 to 8 hours prior to the procedure and certain medications may need to be stopped. During the procedure a specialised tube called a duodenoscope which contains a light and camera is used to access the first part of the small intestine through the mouth and stomach. Dye is injected into the bile ducts and an x ray is taken to study the biliary system. Further procedures can then be performed such as stone extraction or stent insertion. ERCP may be done as a day case or require overnight stay in hospital. Less severe complications include a sore throat, mild abdominal pain and mild pancreatitis. More severe complications include pancreatitis, bleeding, infections, damage to bowel, and in rare cases death.
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