Preparation for ERCP Procedure

You should not eat or drink anything for at least six hours (preferably overnight) before the procedure to make sure you have an empty stomach, which is necessary for the best examination.  If the examination is performed at noontime, a cup of tea, juice, milk, or coffee can be taken 4 hours earlier.  Heart and blood pressure medications should always be taken with a small amount of water in the early morning.  You should talk to your doctor about medications you take regularly and any allergies you have to medications such as antibiotics.  Tell your doctor if you have an allergy to iodine-containing drugs, which include contrast material.  Although an allergy doesn’t prevent you from having ERCP, it’s important to discuss it with your doctor prior to the procedure.  Also, be sure to tell your doctor if you have heart or lung conditions, or other major diseases. 

ERCP can be done either as an outpatient procedure or may require hospitalization; it depends on the individual case.  Your doctor will explain the procedure and its benefits and risks, and you will be asked to sign an informed consent form.  This form verifies that you agree to have the procedure and understand what’s involved including the potential risks. 

How is an ERCP performed?

Everything will be done to ensure your comfort.  Your blood pressure, pulse, and the oxygen level in your blood will be carefully monitored.  Your doctor might apply a local anesthetic to your throat or give you a sedative through a vein in your arm to make you more comfortable.  You will feel drowsy, but will remain awake and able to cooperate during the procedure.  You will lie on your stomach on an X-ray table. 

An endoscope will be passed through your mouth, esophagus, and stomach and into the duodenum.  This instrument does not interfere with your breathing, but you might feel a bloating sensation because of the air introduced through the instrument.  In the duodenum, the instrument is positioned near the papilla, the point at which the main ducts empty into the intestine.  A small tube known as a catheter is threaded down through the endoscope, which can be directed into either the pancreatic or common bile duct.  The catheter allows a special liquid contrast material, a dye, to be injected backwards through the ducts.

X-ray equipment is then used to examine and take pictures of the dye outlining the ducts.  In this way, widening, narrowing, or blockage of the ducts can be pinpointed.  The procedure can last any where from fifteen minutes to one hour depending on the anatomy or abnormalities in that area.

What can you expect after your ERCP?

If you have an ERCP as an outpatient, you will be observed for complications until most of the effects of the medications have worn off.  You might experience bloating or pass gas because of the air introduced during the examination.  You can resume your usual diet unless you are instructed otherwise.  However, if you notice bleeding from your rectum or black, tarry stools, call your doctor.  You should also report vomiting, severe abdominal pain, weakness or dizziness, and fever of 100 degrees.  Fortunately, these problems are not common.