ERCP (imaging of the biliary and pancreatic duct)
It is an examination of a bile and/or pancreatic duct. Here, in an endoscopic way (as with gastroscopy), a contrast agent is injected into the biliary and pancreatic ductal system and is represented radiologically.
Amongst others, it is applied for:
- diagnostics und therapy of different diseases of the biliary and pancreatic ductal system
- removal of bile duct stones without surgery or before the operation on gall bladder
- removal of stones from the pancreatic duct
- dilatation of occlusions in the respective ductal systems
- insertion of stents (metal grid and plastic tubes) at the occlusions of the biliary and pancreatic duct
- biliary endoscopy with a “baby-endoscope”.
What does an examination look like and what should I pay attention to?
During the ERCP, an endoscope is inserted through the mouth, as in the case of gastroscopy. The patient should not consume any food 6 hours before the procedure either.
Your referring physician should inform you about the process of examination and possible risks (with a declaration of consent). If necessary, we are also pleased to be at your disposal. Your general practitioner should get your blood count and blood coagulation measured in advance and you should bring these values to the procedure.
It is advisable to stop taking Aspirin-containing preparations or medication, impairing blood coagulation, such as e.g. Plavix® (clopidogrel), 5-7 days before the procedure. Your physician and we as well (especially with Marcumar patients) will be pleased to answer any of your questions.
Imaging of biliary or pancreatic ducts is carried out with the help of an iodine-containing contrast agent. If you are allergic to iodine, you should discuss it with your physician in advance.
During the procedure, diseased processes in the area of ducts can be discovered immediately and e.g. bile duct stones can be removed or occlusions can be connected. If necessary, the orifice of the bile or pancreatic duct can be extended to the small intestine (papilla) by means of a small incision (papillotomy). This intervention is carried out through the working channel of an endoscope and is absolutely painless.
The examination is performed under x-ray control and takes about 30 minutes, the interventions can take longer.
As a rule, the procedure is performed under a sedative injection.The patient will sleep during the procedure and then he can rest in the recovery room. Because of the special medication (propofol), there is no long lasting after-effect, as with valium related preparations. However, for legal reasons, you are not allowed to drive a car for 24 hours after the injection.
The most frequent possible complication is pancreatic irritation that can occur because of the manipulation at the ducts and administration of a contrast agent. Pancreatic irritation can occur in 8% of cases. It is characterised by abdominal pains, is, as a rule, harmless and is treated by a short-term fasting and infusions. Therefore, it is necessary for the patient to stay under control at the clinic for about 4 hours after the procedure. Upon agreement with your physician, you can take a meal on the evening of the examination day. In some cases, it is reasonable to stay for an inpatient follow-up treatment. In some rare cases (ca. 0,5 – 1%), a strong inflammatory response of the pancreas may occur, which requires a hospital stay.
