Frequently Asked Questions

What happens during an ERCP?

During an ERCP, you will lie on your side and the doctor passes the endoscope through the mouth, esophagus and stomach and into the duodenum. The tube will not affect your ability to breathe normally.  Once the physician reaches the spot where the duct of the biliary tree and the pancreas open into the duodenum, he or she will pass a small plastic tube through the scope. Using this tube, he will inject dye into the ducts. This allows the ducts to show up on x-ray and enables the physician to visualize the bile ducts. Tissue samples and brushing of the ducts can also be taken.

If the exam shows stones in the bile duct or pancreatic duct, the physician will insert other probes or catheters through the scope to help remove the stone. In some cases, the physician may place a small plastic tube, called a stent in the affected duct to allow any remaining stone or stone material to pass.

If a narrowing is discovered, the physician will insert other probes or catheters into the duct. He or she may dilate (stretch the duct) in help relieve the narrowing. The physician will place a small, plastic tube, called a stent, into the duct to help keep the duct open. If a stent is placed, you have to return for a repeat ERCP in 8-12 weeks.

In the cases of malignant lesions that are compressing the bile duct, the physician will place either a small plastic tube, called a stent, or a permanent metal stent into the affected duct.

What is the difference between a plastic or metal stent?

A plastic stent is placed to provide temporary relief of stricture, bile leaks, and to help with the passage of stone material. When plastic stents are placed, you must return, usually in 8 to 12 weeks, for a repeat procedure to either remove or replace the stent.

Metal stent or permanent stents are placed in cases when a malignancy if found and surgery is not indicated. The stent does not have to be removed.

What complications can occur with an ERCP?

Complications include infection of a pancreatitis (inflammation of the pancreas),  gastrointestinal bleeding, infection, perforation of the duodenum, and reactions to anesthesia medications. You may experience a sore throat for a day or more. Pancreatitis can occur in roughly 5-10% of cases. Other complications are very rare, occurring in less than 1% of cases.

What happens if I get post-procedure pancreatitis?

If your physician feels that you have signs or symptoms of pancreatitis, you will be admitted to the hospital.

What should I do to prepare for an ERCP?

In general, the patient will not be allowed to eat or drink anything before the examination. (Please refer to the instructions that will be given to you). You may have to stop or adjust certain medication prior to your procedure. You will be given specific information regarding these medications.

What can I expect before an ERCP?

You will be asked to report to the report to the Endoscopy Unit an hour prior to your scheduled time. Upon entering the Endoscopy Unit, the nurse will start an IV in your arm. The doctor will speak with you prior to the ERCP. He or she will explain the procedure and its risks. You will then be asked to sign an informed consent given your permission and understanding of the procedure.

What can I expect during an ERCP?

Just before the ERCP, the patient will receive sedative medication through the IV in the arm.  Since sedative medications are used, the patient should prepare in advance to have someone else drive him/her home after the procedure.  ERCP is performed under heavy conscious sedation. Most patients are asleep during the procedure and experience little or no discomfort.

What can I expect after an ERCP?

After the ERCP procedure is completed, the patient will remain in the recovery room until the sedative medication has worn off.  The patient should not drive a vehicle after receiving sedative medication.  It is not unusual for the patient to experience a feeling of fullness or the need to pass gas after the procedure.  The healthcare team will provide instructions regarding eating and drinking following an ERCP procedure.

The doctor will speak with you once you are awake to discuss his/her findings and recommendation. Since you may still be under the effects of the sedation, it is generally recommended that a family member or person of your choosing is present to hear the discussion with the doctor. At this time, the physician will assess you for any signs or symptoms of pancreatitis. If you display any symptoms, you may be admitted to the hospital for observation.

What happens if a biopsy is done?

In general, it will take 2-3 working days for the final results. When the final results are obtained, you doctor will contact you with the results and further recommendations.