Center for Digestive Diseases

UNM Hospitals Center
for Digestive Diseases

Address:
1001 Martin Luther King Ave. NE
Albuquerque, New Mexico 87106

Appointments:
(505)272-2530 or
(505)925-6000

Facsimile:
UNMH: (505)272-6839
CDD: (505)925-7849

Endoscopic Retrograde CholangioPancreatography


What is ERCP?

ERCP (Endoscopic retrograde cholangiopancreaticography) is an outpatient procedure that involves passage of an illuminated flexible tube with a side viewing camera through the mouth and advanced into the stomach and first portion of the small intestine (duodenum).  Examination of the bile and pancreatic duct is performed using a dye through a tiny opening in the duodenum known as ampulla.


The UNM Division of Gastroenterology performs the largest number of ERCP 's in the state of New Mexico and serves as the referral center for the state and the surrounding areas.  Various ERCP services include:

1. ERCP with extraction of bile duct and pancreatic stones including mechanical and laser lithotripsy.

2. ERCP with stent placement (plastic and metal) stent placement for bile leaks, ductstrictures (narrowing) or stones.

2. ERCP with cholangioscopy and pancreatoscopy for diagnosis of tumors.

4. ERCP for treatment of patients with chronic pancreatitis.


Why is ERCP performed?

ERCP is most commonly performed to diagnose and treat a number of diseases of the pancreas and bile ducts.  ERCP is used for removal of common bile duct and pancreatic duct stones, diagnosis of bile duct and pancreatic duct tumors as well as for placement of small tubes (stents) in bile and pancreatic duct to bypass the blockage caused by tumors or scarring.


What preparation is required?

An empty stomach allows for the best and safest examination.  Therefore, you should have nothing to eat or drink for six hours before your procedure.  If you have any questions about dietary recommendations, please call the UNMH endoscopy center at 505 272 0781 (Fax: 505 925 6160).


Procedure Preparation Instructions


Can I take my current medications?

Most medications can be continued as usual, but your doctor may recommend to stop some medications such as blood thinners, ie warfarin (Coumadin), enoxaparin (lovenox), clopidogrel (Plavix). Tell your doctor about all your medications and your allergies.  If there are any medications that you are not sure about taking, please consult your doctor beforehand or call the UNMH endoscopy center at 505 272 0781 (Fax: 505 925 6160).


What happens during ERCP?

ERCP is an outpatient procedure and is usually performed under general anesthesia, administered by an anesthesiologist or nurse anesthetist. A flexible tube with a light and camera is gently inserted through the mouth and advanced to the stomach and duodenum (first portion of the small intestine). After finding the opening of the biliary and pancreatic ducts in the duodenum an X-ray contrast material (iodine dye) is injected into the pancreatic or bile ducts and further tests such as stone removal or stent placement is performed. The procedure itself usually takes approximately one hour, although you should plan to be at our endoscopy center for approximately four hours. This will include the registration, preparation, procedure and one to two hours of recovery time.


What happens after ERCP?

The doctor will explain the results to you.  If biopsies or other samples were obtained, your doctor will send you a letter with those results within 1-2 weeks. Due to the use of anesthesia  during your procedure someone will need to drive you home from the endoscopy center and stay with you. Even if you feel alert, your reflexes and judgment may be impaired. You will not be able to work for the rest of the day. In most cases you will be able to eat after the examination, but occasionally the doctor will recommend a limited diet.


What are possible complications of ERCP?

ERCP is generally safe when performed by a gastroenterologist trained and experienced in these procedures.  Mild sore throat lasting a few days is common and mild bloating related to air insufflation of the intestines is common and usually improves after passage of gas.  The risk of complications is similar to that of standard endoscopic procedures.  Possible complications include: pancreatitis, infection, reactions to the sedatives or complications of heart of lung disease, bleeding, and bowel perforation/tear (very rare).  Bleeding usually stops on its own or can be controlled during the endoscopy; rarely blood transfusion is necessary.  If perforation occurs your doctor will recommend hospitalization, antibiotics and possibly surgery.  You will be monitored by an anesthesiologist, nurse anesthetist or registered nurse throughout the procedure for any problems with sedation, breathing or heart problems.  Contact your doctor if you notice severe chest pain, abdominal pain, fever, chills, vomiting or passage of dark tarry stools. Note that bleeding can occur several days after the procedure. This bleeding can usually be controlled with repeat upper endoscopy.


Dedicated Specialists in this procedure:

Dr. Gulshan Parasher
Dr. Arun Pillai