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ERCP (or ERCP in English) stands for Endoscopic Retrograde Cholangiopancteatography. It is a diagnostic method which is a combination of endoscopic and X-ray examinations.
What is ERCP?
ERCP is one of the most effective methods of diagnosing diseases of the bile ducts, pancreatic ducts and the pancreas. ERCP is also used to perform procedures – usually these two aspects are combined (diagnostic and therapeutic) – ERCP is an invasive method and carries the risk of complications, so it is rarely used only for diagnostic purposes.
ERCP is a combination of an endoscopic method and a radiological examination. It allows you to remove deposits from the bile and pancreatic ducts, you can use it to put on prostheses, widen the bile ducts or take samples for further examination. ERCP allows in many cases to avoid surgery.
When is ERCP performed?
ERCP is performed when there is a suspicion of an obstacle in the bile outflow (this method allows you to accurately locate the obstacle and remove it during the examination), in the case of pancreatic diseases, including neoplastic diseases, and in the case of chronic inflammation of the bile and pancreatic ducts.
Symptoms most often prompting a doctor to decide whether ERCP is necessary are jaundice and abdominal pain suggesting an obstacle in the outflow of bile, deposits in the pancreatic and bile ducts (ductal stones), pancreatitis, changes in organs adjacent to the bile ducts, and pancreatic tumor .
During the ERCP examination, specimens are taken for histopathological examination, it is also possible to remove deposits in the bile ducts and remove stones from the pancreatic ducts.
How is ERCP performed?
During ERCP, a duoendoscope is inserted into the duodenum and around the Vater’s nipple, where the patient’s bile and pancreatic ducts meet. A contrast agent is administered to the bile and pancreatic ducts, and then their image is assessed using X-ray images. This allows you to accurately recognize possible changes in the biliary and pancreatic ducts and use an appropriate method of treatment during ERCP.
How to prepare for the ERCP study?
The patient should report to ERCP on an empty stomach. Before ERCP is performed, tests such as blood count, coagulation tests, blood electrolyte levels and thyroid hormone levels are required. The doctor may additionally order a blood group test, amylase activity, urea concentration and an ECG.
In patients taking insulin, they should skip the dose of insulin before the ERCP test is performed, as is the case with anticoagulants, preparations containing salicylic acid, clopidogel or ticlopidin.
Some patients require heparin prior to ERCP.
Possible complications after ERCP
ERCP is an invasive procedure, but when performed by an experienced physician, it should not lead to any complications. Nevertheless, in some cases, symptoms of mild pancreatitis or bile duct inflammation may appear. It may also cause bleeding and perforation of the gastrointestinal tract.
ERCP is performed under anesthesia, therefore, side effects related to the administration of anesthesia may also occur.
How should you behave after ERCP?
After ERCP, fasting should be continued until your doctor approves food intake. If you experience any disturbing symptoms such as pain, vomiting, blood in your stools or black stools, report them to your doctor immediately.
After ERCP is performed, the patient remains in the hospital for XNUMX hours and his condition is monitored. If the patient goes home on the day of the procedure, he or she must not drive, and care is required at home.