ERCP test

ERCP stands for Endoscopic Retrograde Cholangio Pancreatography. Doctors use this test to diagnose conditions of the liver, bile ducts, pancreas and gall bladder. They pass a tube called an endoscope down your throat to take an X-ray of the pancreas and gall bladder. The endoscope is a long flexible tube with a small camera and light at the end.

The doctor can look down the endoscope and see if there are any growths or other abnormal looking areas in the pancreas or gallbladder. They can take samples (biopsies) of any abnormal looking areas. The test takes between 30 minutes and an hour.

About 2 days before the ERCP you usually have a blood test to check how well your blood clots. If you are taking any medicines that change how your blood clots, it is very important to let your doctor know. These medicines include aspirin, arthritis medicines, warfarin (Coumadin), or any other blood "thinners".

You can have an ERCP test as an outpatient. You can't eat or drink for about 8 hours before the test so that your stomach and small bowel (duodenum) are empty. Your doctor will give you written instructions about this beforehand, or the instructions may arrive with your appointment letter.

When you get to the clinic, the nurse may ask you to take your upper clothing off and put on a hospital gown. Once you are ready, you get onto the bed or X-ray couch.

When you are lying on the couch, the nurse may put a drip (intravenous infusion) into the back of one of your hands. You may have antibiotics through the drip, to prevent infection. You may also have fluids through the drip during the ERCP. You have an injection first to make you very drowsy. And your doctor will spray the back of your throat with local anaesthetic to make it easier to swallow the endoscopy tube.

You will need to take someone with you to the hospital appointment. You won't be able to drive for the rest of the day and should have someone to go home with you.

Once the sedative and throat spray has worked, the doctor passes the endoscope tube down your throat to the area where the pancreas and bile ducts join the small bowel (duodenum). Your doctor will ask you to swallow as the tube goes down. If you've had a sedative, you won't remember that afterwards.

Through the endoscope, your doctor can see the inside of the stomach and small bowel. They then inject dyes into the channels (ducts) in the biliary tree and pancreas so they can see them on X-rays. If there are any abnormal areas, the doctor will take pieces of tissue (biopsies) to send to the laboratory for examination under a microscope.

When the test is over you will need to rest for a while and may need to stay in the department for a few hours. If you've had a sedative, you may not remember much (if anything) about the test once you have come round. You should be able to go home the same day.

Possible problems after ERCP include pancreatitis (inflammation of the pancreas), infection, bleeding, and a hole (perforation) in the duodenum. Pancreatitis can happen in up to 1 in 10 people but the other problems are very uncommon. You may have tenderness or a lump in your hand where you had the sedative injection, but that should go away in a few days.

It can take time for test results to come through. How long will depend on why you are having the test but it may be a couple of weeks. Usually, the doctor who does the endoscopy writes a report straight way. The report is sent to your specialist, who gives the results to you. If your GP has sent you for the test, the results will go directly to the GP surgery.

Understandably, waiting for results can make you anxious. If your doctor asked for them urgently, it would have been noted on the test request form and the results will be ready quickly. Try to remember to ask your doctor how long you should expect to wait for the results when you are first asked to go for the test. If it is not an emergency, and you have not heard a couple of weeks after your test, ring your doctor's secretary to check if they are back.