FREQUENTLY ASKED QUESTIONS

WHAT IS AN ERCP?

ERCP is a procedure that combines upper gastrointestinal (GI) endoscopy and real-time x-rays to treat problems of the liver, bile duct, and pancreas. During the procedure, an endoscope (a long narrow flexible tube with a camera and light at its end) is passed into the mouth and down the esophagus to view the lining of the stomach and the first part of the small intestine (the duodenum). From here a small wire and catheter can be inserted into the bile duct and/or pancreas. The doctor can inject contrast dye into the ducts and takes x-ray pictures to show problems such as stones, strictures, or blockages. Some of these can be treated right away with other tools passed through the endoscope.

WHAT IS THE PURPOSE OF AN ERCP?

Doctors use ERCP to treat problems of the bile duct and pancreatic duct. Problems include, but are not limited to:

  • Stones and leaks in the bile duct or pancreas 

  • Blockage of the bile duct or pancreas  by cancer, stricture, or compression from adjacent organs

  • Jaundice (yellow coloring of the skin) due to obstruction of the bile duct, also causing darkening of the urine and light colored stool

  • Recurrent attacks of unexplained pancreatitis 

  • Pre-cancerous growths at the opening of the bile duct and pancreas (ampullary adenoma) 

WHAT ARE THE RISKS OF AN ERCP?

The most common complication of ERCP is pancreatitis (swelling and inflammation of the pancreas). This generally occurs in about one patient out of twenty patients, and results in the need to stay in the hospital for pain medications and IV fluids. Pancreatitis usually lasts for just a few days, but can be much more serious.

Other less common complications include, but are not limited to:

  • Heart and lung problems

  • Bleeding (after sphincterotomy)

  • Infection (in the bile duct, called cholangitis)

  • Perforation (a tear or hole in the intestine)

HOW LONG DOES AN ERCP PROCEDURE NORMALLY LAST?

An ERCP procedure typically lasts about 30-90 minutes. The time of the procedure can differ based on the complexity of the case.

To learn more, please visit: https://www.niddk.nih.gov/health-information/diagnostic-tests/endoscopic-retrograde-cholangiopancreatography#use

HOW DO DOCTORS PREVENT PANCREATITIS AFTER ERCP?

Your endoscopist will have a comprehensive plan to reduce the risk of pancreatitis after ERCP. This starts with considering whether the benefits of ERCP truly outweigh its risks and whether there are alternative, less invasive tests that can address your problem. During the procedure, the endoscopist will take great care to minimize injury to the pancreas by working as efficiently and gently as possible and limiting the amount of contrast dye that is injected into the pancreas. Additionally, the team will administer indomethacin, a medication that has been shown to reduce the risk of pancreatitis. When this risk is high, he or she may elect to place a pancreatic stent, which helps the pancreas drain adequately. The purpose of the SVI trial is to determine – since the stent has some downsides – whether it adds significant value over the medication alone. During and after the procedure, you may receive a form of IV fluids that has also been shown to reduce risk.

DO I HAVE TO COME BACK FOR THE RESEARCH STUDY AFTER MY PROCEDURE?

There is no need to return for research purposes if you participate. If you are enrolled in the trial, a member of your research team will contact you via telephone a few days after your ERCP to check in on you, and then will contact you again about 30 days after your ERCP. After this, your participation in the study will be complete.