Endoscopic Retrograde Cholangio Pancreatography (ERCP)

Endoscopic Retrograde Cholangio Pancreatography (ERCP) is an endoscopic procedure to examine the bile duct and pancreas duct. It involves a long thin flexible endoscope being inserted through the mouth, past the stomach into the duodenum (the first part of the small intestine). From the duodenum, a catheter and guidewire are placed into the bile duct. Dye is injected into the bile duct, and X-rays are taken to show bile duct stones, or narrowings of the bile duct. Stones can be removed, and stents can be placed into the bile duct.


For this procedure to be successful, your stomach needs to be empty

Do not have anything to eat or drink 6 hours before the procedure

Please make arrangements for someone to collect you from the unit and care for you for 24 hours after the procedure. This is for your own safety and protection. The anaesthetic makes you forgetful and can impair your judgment and reflexes

Even if you feel alert after the procedure you must not do any of the following for 24 hours:

  • Drive a car
  • Operate machinery
  • Drink alcohol
  • Sign any legal document or
  • Ride on public transplant alone.

What should I expect:

Intravenous fluids may be started before the ERCP. A diclofenac suppository (anti-inflammatory) is given to reduce the risk of pancreatitis. The procedure will be performed in an operating theatre with an X-ray machine present, with you lying on your front. . An anaesthetist will be making you deeply asleep. A mouthguard is often inserted as you are drifting off to sleep. The procedure can take 10-60 minutes.

After your ERCP procedure you may have a sore throat which can last for up to 24 hours. Your stomach may also feel bloated from air in the stomach during the procedure. This will settle over the next few hours as you pass wind naturally

Depending on how difficult the procedure is, you may drink fluids after till 5pm, then have a light dinner.  The next day you may eat and drink normally.


The main risk of ERCP is pancreatitis – inflammation of the pancreas at 5%. Most of the time if this happens, it is mild, requiring hospital admission for 3-7 days. Serious cases of pancreatitis can result in long hospital admissions – for months, often requiring further surgical or radiology procedures, and extremely rarely resulting in death.

1-3% of patients can develop bleeding or bowel perforation. This may require further procedures, and very rarely surgery. Other problems can include incomplete removal of stones requiring further ERCP, or bile duct infection requiring antibiotics

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