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Endoscopic Retrograde Cholangiopancreatography (ERCP)

ERCP is the abbreviation for endoscopic retrograde cholangiopancreatography. It is an x-ray exam of the passages or ducts leading from the pancreas and gall bladder into the intestine. These organs are next to the liver and stomach. They secrete enzymes and fluids, important for digestion, through the ducts at the top of the small intestine.

Sometimes crystals form stones that block the passages. The duct from the gall bladder is called the bile duct. It empties a system of ducts from the liver. If the bile duct is blocked, liver products build up in the body and cause jaundice, a yellow coloring of the skin. If the pancreatic duct is blocked, digestion shuts down and the pancreas becomes inflamed. ERCP helps find the cause of liver and pancreas disorders and also helps diagnose cancer in these sites. At the time of ERCP, biopsies, surgery, and instilling medication can also be performed.

ERCP is an outpatient procedure. It usually lasts about 30 to 60 minutes. Food must not be eaten after midnight the night before the test. The person takes a mild sedative to relax, but is awake during the test. The examiner sprays the mouth with a local anesthetic to prevent gagging on the endoscope. Intravenous drugs relax the muscles of the stomach and small intestine. These drugs may have some unpleasant side effects, such as nausea, vomiting, hives, dry mouth, thirst, blurred vision, and retention of urine.

Examiners perform ERCP with the help of an endoscope. An endoscope is a long, flexible scope. The examiner passes the endoscope through the mouth and down to the small intestine. A thin tube is then passed through the endoscope. The tube delivers a contrast dye. Examiners view the pancreas and ducts by fluoroscopy and still x-rays. Fluoroscopy uses continuous x-rays to create a moving image. The examiner may take a biopsy or widen a duct before removing the endoscope.

After the test, the person usually is observed for several hours. The person may feel dizzy, nauseated, or bloated for a while, and should not eat or drink until the gag reflex returns. A sore throat may occur for 3 or 4 days. Throat lozenges and gargling with warm salt water soothe this pain. There is a slight risk that the procedure itself may cause inflammation of the bile ducts or the pancreas.

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