ERPC

An Endoscopic Retrograde Cholangio-Pancreatography (ERPC) is a test that allows your doctor to examine your pancreas and bile duct and take an X-ray picture. You will need to come into hospital for an ERCP. The actual test will take place in the X-ray department or endoscopy suite.

Your doctor can use the information from the ERCP to diagnose and treat blockages that cause jaundice (yellowing of the whites of the eyes and skin).

Preparation
The day before your ERCP, you may need to attend a pre-admission clinic so that we can take some blood for tests. Please tell the nurses if you suffer from allergies, diabetes, glaucoma, or take Warfarin (or other blood-thinning tablets, e.g. clopidogrel).

You normally have nothing to eat (6 hours) or drink (2 hours) before your test.

What happens?
When you come into hospital the doctor will put a small a needle into the back of your right hand so that you can have some sedation. You will then need to lie on your left-hand side with your left arm behind your back. The nurse who is looking after you will place a clip on your finger to monitor your pulse rate and oxygen levels. You may also be given some oxygen into your nose.

The doctor will pass an endoscope tube down your oesophagus into your stomach. The tube then passes into the first part of your small bowel (the duodenum), where the opening to the ducts leading to where the liver and pancreas are. The doctor then passes a narrow plastic tube, called a catheter, down through the endoscope and into this opening.

He/she will then inject an X-ray dye through the catheter so that the bile ducts and the pancreas can be seen clearly on X-ray. The dye used is harmless and will pass out of your body naturally. If the doctor sees a narrowing, he/she can put a small plastic tube, called a stent, into the bile duct to drain the bile in to the duodenum and relieve the blockage. (If the bile has not been able to drain properly, you may be jaundiced.)

If the doctor sees any abnormalities, he/she will take a biopsy. Cell samples, called “brushings”, can also be taken from inside the small ducts. These biopsies and/or cell samples will be sent to the pathology department and examined closely under a microscope. It will take several days before the results are known. The doctor may take some photographs of the area for closer examination later.

How long does the test take?
The test can take between 25 and 30 minutes.

How will I feel after the test?
You will come back to the ward in your bed and a nurse will check your pulse and your blood pressure regularly until you are fully awake. You may feel sleepy for a couple of hours because of the sedation. After you have been back in the ward for about two hours we may take some blood to check if there has been any irritation to your pancreas (pancreatitis) after your ERCP. If you develop pancreatitis, you will need to stay in hospital until it settles.

You may well need to stay in hospital overnight, depending on when in the day the test is carried out and also on the complexity of the procedure.

If you are allowed home on the same day as the test, then you will need someone to look after you for the next 24 hours. It takes this long for the sedation to leave your system, and during this time you must not drive, operate heavy machinery, make any important decisions, or take any alcohol.