ERCP - Endoscopic Retrograde Cholangio Pancreatography

What is an ERCP?

It is a test that allows the endoscopist to diagnose and treat problems with the tubes (ducts) draining the gallbladder, pancreas, and liver (the drainage routes of the liver are known as bile ducts).




To do this test an endoscope (a thin flexible tube approximately the size of an index finger) is passed through your mouth, through the stomach and into the duodenum (first part of the small intestine). Once in the duodenum a catheter (a thin plastic tube) is passed through the endoscope and into the opening of the pancreatic duct and bile ducts.

X-ray dye is gently injected and x-ray pictures are taken. These problems would normally have been picked up by either an ultrasound, CT scan, MRCP, or MRI scan.

Preparation for the examination

  • The day before the ERCP you will need to have a blood test and medical assessment. These blood tests are dependent on the requirements of your consultant.
  • You will be asked not to eat or drink for several hours before the test. Your Pre assessment Nurse will advise you when to begin this period of nil by mouth.
  • If you are a diabetic or haemophiliac, please phone Spencer Private Hospitals for specific advice.
  • If you might be pregnant, please inform us as soon as possible.
  • If you are taking warfarin, clopidogrel, or other blood thinning medications please inform us as soon as possible.
  • If you have a pacemaker, ICD or other implant device, please inform us at least one week before the test.
  • Continue to take your medications with a sip of water. Please bring a list of them with you to the unit.
  • If you have any queries about your medication, please ring Spencer Private Hospitals. It is especially important to remember to bring any asthma inhalers or angina sprays with you.
  • Please remove your nail polish and all types of false nails before attending for your procedure.
  • Please bring with you your dressing gown, slippers, and something to do during your stay.
  • Do not bring any valuables to the unit.


ERCP is generally a well-tolerated procedure. There is a small risk of the following:

  • Damage to crowned teeth or dental bridgework.
  • Inflammation of the pancreas: this is called pancreatitis. It can be painful, causing abdominal pain and sickness, and usually requires some days in hospital for intravenous fluids and painkillers. On very rare occasions it may be very severe. The risk of pancreatitis occurring is 1 to 2%, (which is one in 50 to 100 patients).
  • A reaction to the sedative. The sedative can affect your breathing making it slower and shallower.
  • Bleeding: if a cut is made into the bile duct to remove a gallstone, there is a risk of bleeding. This risk is approximately 1% (which is one in a 100 patients). Bleeding can often be treated immediately through the endoscope and is rarely a major complication. If severe it may require a blood transfusion or surgery.
  • Perforation, which is a small tear in the wall of the bowel. This is rare. This would require a short stay in hospital and treatment with antibiotics, or very occasionally may require surgical repair.
  • You may have a sore throat after the test, but this normally clears up in a few days.

Please talk to your endoscopist before your examination if you have any worries about these risks.

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