retrograde cholangiopancreatogram (ERCP) is a test that combines the use of a
flexible, lighted scope (endoscope) with X-ray pictures to
examine the tubes that drain the
The endoscope is inserted
through the mouth and gently moved down the throat into the
esophagus, stomach, and
duodenum until it reaches the point where the ducts
from the pancreas (pancreatic ducts) and gallbladder (bile ducts) drain into
ERCP can treat certain problems found during the
test. If an abnormal growth is seen, an instrument can be inserted through the
endoscope to obtain a sample of the tissue for further testing (biopsy). If a gallstone is present in the
common bile duct, the doctor can sometimes remove the
stone with instruments inserted through the endoscope. A narrowed bile duct can
be opened by inserting a small wire-mesh or plastic tube (called a stent)
through the endoscope and into the duct.
Why It Is Done
ERCP is done to:
- Check persistent abdominal pain or
gallstones or diseases of the liver, bile ducts, or
- Remove gallstones from the common bile duct if they are
causing a problem such as blockage (obstruction), inflammation or infection of
the common bile duct (cholangitis), or
- Open a narrowed bile duct or
insert a drain.
- Get a tissue sample for further testing
- Measure the pressure inside the bile ducts (manometry).
How To Prepare
Follow the instructions exactly about when to stop eating and drinking, or your test may be canceled. If your doctor has instructed you to take your medicines on the day of surgery, please do so using only a sip of water.
If your doctor prescribed antibiotics before the test, take them as directed. You need to take the full course of antibiotics.
Tell your doctor if you:
- Have hay fever, hives, food or medication
- Are allergic to shellfish (shrimp,
scallops, lobster), the iodine used in the
contrast material for X-ray tests, or any other
substance that contains iodine.
- Have had a digestive tract study
that used barium, such as a
barium enema, within the last week.
taking blood-thinning medicines, such as aspirin or warfarin (Coumadin).
Talk to your doctor about any concerns you have regarding
the need for the test, its risks, how it will be done, or what the results will
mean. To help you understand the importance of this test, fill out the
medical test information form(What is a PDF document?).
You will be asked to empty your
bladder and remove any dentures, jewelry, or contact lenses before having an
How It Is Done
An endoscopic retrograde
cholangiopancreatogram (ERCP) is done by a doctor trained in
endoscopy, usually a doctor who specializes in
diseases of the digestive system (gastroenterologist). A thin, flexible
fiber-optic endoscope is used.