ERCP (Endoscopic Retrograde Cholangio-Pancreatography)

What is an ERCP?

It is an examination of the first part of your intestines, pancreas and bile ducts.

A long thin flexible tube with a light on the end of it (called an endoscope) is passed through the mouth and into the stomach. It is then passed a little further into the first bend of your intestine, so the doctor can see your pancreas and bile ducts. An x-ray dye is injected into the endoscope so that the pancreas and bile ducts can be seen more clearly. By doing this test the doctor is able to see what may be causing your problems, and on some occasions, may be able to help alleviate them during the test.

What preparation do you need for the ERCP?
  • You will have a medical check-up with a specialist nurse before your test; this will include blood tests and blood pressure checks. Please make a list of anything you may want to discuss about the test.
  • For this examination to be successful, and for the doctor to have a clear view, your stomach and the first bend of the intestine must be empty.
Important – if you are taking Warfarin, Aspirin or Clopidrogrel please contact our clinical team by phoning switchboard on 0207 272 3070 and ask for bleep 2711.

Important – you should not eat or drink anything for at least 6 hours before the test.

  • You will be given a prescription for antibiotic tablets, which you should start taking the evening before the test. This is to prevent an infection.
  • Please bring any tablets or medicines that you are taking with you to the hospital.
When you arrive at the hospital
  • Please go to the reception of the Day Treatment Centre, level 3.
  • There you will see a nurse who will take your blood pressure and pulse and answer any questions you might have.
  • If you are allergic to any medicines, please tell the nurse.
  • You will need to remove any false teeth, glasses, contact lenses and jewellery (metal objects can spoil the x-ray pictures). It is better to come in leaving most of your valuables at home.
  • The test is performed in the Imaging Department. Your nurse will go with you and stay with you throughout the test.
What does the ERCP involve?
  • The doctor will explain the procedure and ask you to sign a consent form.
  • If you have any questions about the test, please ask the doctor at this time.
  • An anaesthetic spray will be used to numb the back of your throat.
  • You will be given an injection of sedative in the back of your hand that will make you feel very sleepy and relaxed.
  • You will be given extra oxygen during the test by soft tubes placed in your nostrils.
  • You will be asked to bite on a mouth-guard (to protect your teeth from the endoscope).
  • When you are feeling sleepy and relaxed, the doctor will pass the endoscope through your mouth and into your stomach.
  • This will not be painful and will not make breathing difficult.
  • The doctor will pass some air into the intestine so that the pancreas and bile duct can be seen clearly. This air will be sucked out at the end of the test.
  • X-ray dye is then injected into the tube so that the pancreas and the bile ducts can be seen on the x-ray pictures.
  • If the doctor sees gallstones during the test, he/she may widen the entrance of your bile duct to let out the stones. This is not painful.
  • If there is a narrowing to the opening of your bile duct, the doctor may put in a small tube (called a ‘stent’) to drain the bile. This tube will be left in place after the test is finished but you will not be aware of it inside you.
  • The test takes between 30 minutes and an hour.
  • If you get a lot of saliva in your mouth the nurse will clear it out with a sucker.
  • When the test is finished the endoscope is removed quickly and easily.
What happens then?
  • You will be taken back to the Day Treatment Centre where you will be allowed to rest for at least 2-3 hours.
  • You may eat and drink as soon as you feel you can swallow normally.
  • The doctor will tell you the result of the test before you go home.
Going home

Important – please make sure that a friend or relative collects you.

  • You should rest for the remainder of the day, but you will be able to return to normal activities the next day.
  • You may feel a little bloated from some air left in your stomach. This will pass and you do not need to take any medicine for it.
  • Please do not drive or work machinery for 24 hours after the procedure.
      Are there any risks?

      An ERCP is a very safe test, but just occasionally, problems can occur:
      • Bleeding inside - this may occur if the doctor has widened the opening to the bile duct. It usually stops after a short time, but if you notice blood in your stools, or you vomit any blood, phone your GP, or come into the hospital emergency department immediately.
      • Inflammation – occasionally, the pancreas can become inflamed, due to the special x-ray dye, in which case you will need to stay on in hospital for a few days.
      • Perforation - a little tear in your intestine, which can happen during the test. This may not need treating at all, but you might have to stay in hospital so that the tear can be repaired surgically.
      If you have any concerns about the test, please discuss them with the doctor before the test.

      Any further questions?

      Please phone us, we will be happy to help.

      If you have a question about your appointment time and/or how to change it, phone our admin team on 0207 288 3820.

      If you have a question about your procedure or your medications, contact our clinical team by phoning the hospital switchboard on 0207 272 3070 and ask for bleep number 2711. Alternatively, phone your GP or NHS Direct on 0845 46 47
      • Last updated26 Jun 2008
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