What is ERCP?

What is ERCP and How is it performed?

From time to time, various problems may occur in the gallbladder or pancreas. ECRP method can be used to diagnose and treat such problems. “What is the ERCP procedure and how is it performed?” performed by gastroenterology specialists. You can find more comprehensive answers to your questions in the rest of the text.

What is ERCP (Endoscopic Retrograde Cholangiopancreatography)?

This treatment, called endoscopic retrograde cholangiopancreatography, or ERCP, is a procedure used to examine the bile ducts and pancreatic ducts, diagnose and treat some conditions. During this procedure, a thin and flexible tube, that is, an endoscope, is entered through the mouth or nose to reach the stomach and duodenum. Thanks to the camera and light at the tip of the endoscope, doctors can carefully observe the bile ducts and pancreatic ducts. ERCP is generally used in patients with serious biliary tract and pancreas problems and should be performed with caution because it is an invasive procedure. The risks and benefits of the procedure should be discussed in detail with the patient by the doctor.

How is ERCP Done?

The process of performing ERCP consists of several steps that require attention and expertise. First, the patient is usually given sedation or anesthesia to ensure that he/she relaxes and does not feel pain. Then, the endoscope, which is a thin and flexible tube, is advanced through the mouth or nose and directed to the stomach and duodenum. Thanks to the camera and light at the tip of the endoscope, the doctor can visually examine the bile ducts and pancreatic ducts.

During the ERCP procedure, a special substance called contrast material is injected into these channels with the help of an endoscope. Contrast material allows the bile ducts and pancreatic ducts to be seen more clearly in images taken with an x-ray device. These images help the doctor learn about possible blockages, strictures, stones, or other abnormalities.

After reviewing the images, the doctor can intervene if necessary. For example, if there is an obstruction in the bile ducts, this obstruction can be opened through the endoscope. Additionally, if gallstones are detected, these stones can be removed with special tools. If there are problems in the pancreatic duct, the doctor can perform the necessary treatments.

However, ERCP is an invasive procedure and involves some risks. There may be infection, bleeding, or other complications caused by the endoscope. Therefore, it is very important that the doctor who will perform this procedure is experienced and offers the most suitable options for the patient. The patient should carefully listen to the doctor’s recommendations and follow the instructions given before and after the procedure.

In Which Situations Is ERCP Applied?

ERCP is generally preferred to detect and solve problems in the bile ducts, pancreatic ducts and duodenum. Some situations where ERCP is applied include:

• Gallstones: Stones formed in the bile ducts can cause acute pain, jaundice and infections. ERCP is used to diagnose these stones and remove them through an endoscope.
• Obstructions and Stenosis: Obstructions and narrowings may occur in the bile ducts and pancreatic ducts. These conditions block the normal flow of digestive fluids and can cause pain, bloating, and other symptoms. ERCP is used to place stents or balloons to help open these blockages and narrowings.
• Bile Tract Inflammations: Inflammations may develop in the bile ducts, which may lead to symptoms such as pain, jaundice and fever. ERCP can help diagnose the source of inflammation.
• Pancreatitis: Inflammation of the pancreas, or pancreatitis, can lead to severe abdominal pain, vomiting, and other symptoms. ERCP can help treat pancreatitis by detecting blockages or other problems in the pancreatic ducts.
• Cysts and Tumors: Cysts and tumors may occur in the bile ducts and pancreatic ducts. ERCP can be used to diagnose these formations and take biopsies when necessary.

The risks and benefits of ERCP should be evaluated and the decision should be made based on the patient’s health status and symptoms. Since the procedure is invasive, the doctor’s experience and the patient’s condition must be taken into account. In all cases, it is important to follow the doctor’s recommendations and ask openly questions about the procedure.

Treatment with ERCP

ERCP is a very effective method in the diagnosis and treatment of biliary tract problems. Thanks to advanced imaging techniques and the experience of expert healthcare professionals, patients can regain their health. However, as with any medical procedure, the advantages and risks of ERCP should be carefully evaluated and action should be taken in accordance with the recommendations of a specialist doctor.

What Should Be Done Before ERCP?

It is important to follow the following steps before the endoscopic retrograde cholangiopancreatography (ERCP) procedure:

• Following Doctor’s Instructions: You must strictly follow the instructions given by your doctor before the ERCP procedure. These instructions may include fasting time, medication use, and other important information before the procedure.
• Fasting Period: Generally, the stomach must be empty for the ERCP procedure. You should not eat or drink water for the period recommended by your doctor. This will help better visualize the stomach and intestines during the procedure.
• Medication Use: If you use medication regularly, you should not stop your medication without consulting your doctor. Your doctor can decide whether to take medications if he deems it necessary.
• Sharing Medical History: You should share your medical history with your doctor before the procedure. Information such as previous surgical operations, allergies or chronic health problems may affect the precautions to be taken during the procedure.
• Disease Status: If you have any infection, fever or chronic disease (blood pressure, diabetes, autoimmune diseases, etc.) before the procedure, you should inform your doctor about this.
• Transportation Regulations: It is not recommended to drive as a driver after the ERCP procedure due to sedation or anesthesia. You may need to arrange for a companion or transportation after the procedure.

Paying attention to all instructions your doctor recommends before the ERCP procedure and staying in touch when necessary can help the procedure be performed smoothly and safely.

What are the Risks and Complications of ERCP?

The endoscopic retrograde cholangiopancreatography (ERCP) procedure may involve some risks and potential complications:

• Infection: Infection may develop in the areas where the endoscope is used. If fever, pain or signs of infection are noticed after the procedure, a doctor should be consulted immediately.
• Pancreatitis: Pancreatitis refers to inflammation of the pancreas and may rarely occur after the ERCP procedure. It may manifest itself with symptoms such as severe abdominal pain, nausea and vomiting.
• Bile Duct Damage: There is a risk of damage to the bile ducts or pancreatic ducts during the ERCP procedure. In this case, additional surgical intervention may be required.
• Bleeding: There is a risk of bleeding during or after the procedure. Signs of bleeding may include dark stools or vomiting.
• Drug Reactions: Allergic reactions may occur to the sedation or anesthesia used.
• Difficulty in Swallowing: Temporary difficulty in swallowing may occur due to the instruments used during the procedure.
• Reflux: The backflow of stomach contents into the esophagus after the procedure is called reflux.
• Ulcers or Sores: Ulcers or sores may occur in the areas where the endoscope is used.
• Intestinal Perforation: In rare cases, there is a risk of the endoscope perforating the intestinal wall.
• Sedation or Anesthesia Related Risks: Respiratory problems or circulatory problems may occur depending on the sedation or anesthesia used.

These risks and complications may differ for each patient. ERCP procedure should be performed under the supervision of an expert and experienced medical team. Before the procedure, you should discuss the risks and benefits in detail with your doctor and consider alternative treatment options when necessary.

What to Do After ERCP?

It is important to follow the following steps after the endoscopic retrograde cholangiopancreatography (ERCP) procedure:

• Observation and Rest: The effect of sedation or anesthesia used during the procedure may continue, so you may be kept under observation for a while.
• Fluid Intake: After the procedure, you can consume fluids slowly, starting with light foods. This helps protect your body from dehydration.
• Monitoring: Your doctor may keep you under observation for a certain period of time to monitor your condition after the procedure. If you have symptoms or complications after the procedure, you should consult a doctor immediately.
• Pain Management: There may be slight pain or discomfort after the procedure. You can relieve this discomfort by using painkillers recommended by your doctor.
• Diet: After the procedure, you should regulate your diet as recommended by your doctor. At first, light and easily digestible foods should be preferred.
• Transportation and Activity: Due to post-procedure effects, you should avoid driving and avoid strenuous activities. Your doctor will let you know when you can return to normal daily activities.
• Medications: You should use the medications recommended by your doctor regularly. If you are prescribed new medications, you should take them as directed.
• Follow-up Appointment: If a post-procedure control or follow-up appointment is arranged, you should definitely go to this appointment. It is important for your doctor to evaluate the result of the procedure and make additional recommendations when necessary.
• Symptoms of Complications: If you notice excessive bleeding, high fever, severe pain or other abnormal symptoms after the procedure, you should contact your doctor immediately.

After the ERCP procedure, you should support your recovery process by fully following your doctor’s recommendations. Paying attention to post-procedure instructions helps minimize possible complications.