ERCP (Endoscopic Retrograde Cholangiopancreatography)

Closeup of common bile duct, pancreas, and duodenum showing ERCP.
A balloon at the tip of a catheter opens above the stone. The stone is pulled out of the duct and leaves your body through stool.

ERCP stands for endoscopic retrograde cholangiopancreatography. This procedure is used to view the biliary and pancreatic ducts.  It is used to evaluate diseases that affect the biliary and pancreatic ducts and to help locate and treat blockages that may be present.

How do I get ready for ERCP?

  • Talk with your healthcare provider about any health problems or allergies you have.

  • Ask your healthcare provider about the risks of ERCP, which include pancreatitis, infection, bleeding, and tearing the bowel.

  • You may be asked to take antibiotics ahead of time.

  • Avoid blood-thinning medicines before ERCP, as recommended by your provider.

  • Don't eat or drink for 8 to 12 hours before ERCP.

  • Have someone ready to take you home.

  • Be sure your healthcare provider knows about all medicines you take. You may be told to stop taking some or all of them before the test. This includes:

    • All prescription medicines

    • Over-the-counter medicines that don’t need a prescription

    • Any street drugs you may use 

    • Herbs, vitamins, kelp, seaweed, cough syrups, and other supplements

What happens during the procedure?

  • You may be given medicine through an IV to help you relax.

  • Your throat is numbed.

  • A thin tube (endoscope) is placed into your throat. It is advanced from the throat through the upper digestive tract, to the common bile duct opening. The endoscope lets the healthcare provider see the common bile and pancreatic ducts on a video screen.

  • A cut may be made where the common bile duct opens to the duodenum to make it easier to remove stones.

  • As blockages are located and removed, X-rays are taken.

  • Contrast dye is injected through a catheter to make the duct show up better on the X-rays.

  • An imaging technique that uses X-rays to obtain real-time moving images of internal organs is called fluoroscopy. It is used to watch and guide progress of the procedure. 

  • In some cases, a plastic tube (stent) is placed to hold the ducts open. This stent may be replaced or removed in 6 to 8 weeks. Or it may be left to fall out on its own and be passed in the stool.

Your healthcare provider may discuss the test results right away or a return visit may be scheduled. Depending on your medical condition and the test results, you may go home the same day or spend the night in the hospital. If you are discharged home, follow these guidelines:

  • Unless told otherwise by your healthcare provider, you can return to a normal routine the day after the ERCP.

  • If a cut was made in the duct, avoid blood-thinning medicines such as aspirin for 5 to 7 days, or as advised by your healthcare provider.

  • Call your healthcare provider right away if you have a fever or abdominal pain. These may be signs of an infection or torn bowel.

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