ERCP is a specialized endoscopic procedure used to evaluate and treat problems in the bile ducts and pancreas. It’s commonly done to remove a blockage or place a stent.
An endoscope is advanced to the small intestine, and imaging is used to evaluate the bile and pancreatic ducts. If a blockage is found, your clinician may remove stones or place a stent to improve drainage. Procedure time varies based on complexity.
ERCP is typically performed with deep sedation or anesthesia and close monitoring. Risks can include pancreatitis, bleeding, infection, perforation, or medication reactions. Your clinician will review your individual risk factors beforehand.
ERCP prep is similar to other upper endoscopic procedures. Your stomach must be empty to lower the risk of aspiration during sedation, so you’ll receive instructions about when to stop eating and drinking before the procedure. If you take blood thinners, diabetes medications, or certain other medicines, you’ll receive specific guidance about which doses to hold or adjust.
You may also be given special instructions based on your overall health, heart or lung conditions, and prior surgeries. Always follow the written directions from Idaho Gastro for your specific ERCP date and time.
On the day of the procedure, you’ll check in, review your medical history, and have an IV started. In the procedure room, monitors will track your heart rate, blood pressure, and oxygen level. You’ll receive sedation or anesthesia through the IV so you’re very relaxed and likely asleep.
The endoscope is passed gently through your mouth into the small intestine. A small catheter is then guided into the opening of the bile and pancreatic ducts. Contrast dye is injected so the ducts show up on X-rays, and your provider can take detailed images. If needed, they may remove stones, widen narrow areas, place stents, or take tissue samples through the scope. When the procedure is finished, the scope and instruments are removed and you’re moved to recovery.
After ERCP, you’ll rest in a recovery area while the sedation wears off. Your throat may feel slightly sore, and you might feel bloated or gassy from air used during the procedure. Your provider will review initial findings and what was done, such as stone removal or stent placement, and talk about next steps and follow-up.
You must have a responsible adult drive you home and stay with you the rest of the day. Avoid driving, operating machinery, drinking alcohol, or making important decisions until the next day. Call your care team or seek urgent care right away if you develop severe or worsening abdominal pain, fever, chills, vomiting, difficulty swallowing, chest pain, or black or bloody stools, as these can be signs of a complication that needs prompt attention.
If your insurance requires a referral or prior authorization, our billing office will make every effort to obtain it before services are rendered. If you choose to proceed without required authorization, insurance may deny coverage. If you are a Medicare patient, you may be asked to sign an Advanced Beneficiary Notice (ABN) acknowledging financial responsibility if insurance does not pay. If you are enrolled in a commercial insurance plan you will be asked to sign a non-covered services form.