Endoscopic Retrograde Cholangio-Pancreatography (ERCP)

What is an Endoscopic Retrograde Cholangio-Pancreatography (ERCP)?

ERCP is a combination of x-rays and an upper gastrointestinal tract endoscopy commonly used to identify or treat problems with the pancreatic or bile ducts in Singapore. These ducts transport digestive juices to the intestines and help in the breakdown of fat in food.

An endoscope is a long, thin, and flexible tube with a camera and light attached to it; the camera and light captures images which are then projected onto a monitor and helps your gastroenterologist identify, diagnose, and treat your problems.

How does ERCP work in Singapore?

Depending on the reason for the ERCP, it is usually performed as an out-patient procedure and can last for a few hours—it can be used for diagnostic and therapeutic purposes.

An anaesthetic spray is sprayed onto the back of your throat to ease discomfort and to prevent gagging.
A sedative is also administered intravenously to help you stay comfortable during the procedure.
The endoscope is carefully and gently guided into your mouth, down through your oesophagus, through your stomach until it reaches the beginning of your small intestine or the duodenum.

Next, a guidewire or catheter is passed through the endoscope and into your bile and pancreatic ducts.
Dye is injected through the catheter into your bile and pancreatic ducts. This dye helps make the ducts more visible during an x-ray.
If necessary, gallstones can also be removed during an ERCP, tumours can be biopsied and stents can be placed to help unblock the ducts.

How do I prepare for an ERCP in Singapore?

Since an ERCP involves the upper digestive tract, you will have to fast for 6 hours prior to your procedure. Inform your gastroenterologist of any medication you may be taking, and of any allergies you may have.

Who needs an ERCP?

Your gastroenterologist may suggest an ERCP if you have the following symptoms:

Jaundice (yellowing of your eyes and skin, pale stools)
Pancreatitis
Pancreatic cancer, pancreatic cysts
Gallstones

What can I expect after an ERCP in Singapore?

Immediately after an ERCP, you can expect to feel some mild discomfort and bloating, this is normal.
You may feel drowsy or nauseated for a few hours. If the ERCP was performed as an out-patient procedure, you will have to wait for an hour or two until the sedative wears off and you might need a relative or friend to accompany you home as you will not be able to drive. However, if the ERCP was performed as an in-patient procedure, you will have to stay overnight at the hospital for close monitoring.
After the test, your doctor will inform you if he/she observed any abnormalities and if samples were taken for a biopsy. If such, your biopsy results should be ready in a few weeks and your doctor will call you with the results. The next step will depend on the results of your ERCP and if applicable, your biopsy.

What are the possible complications or risks of an ERCP?

There are minimal to no risks or complications involved in an ERCP, however, if they do occur, this is what to look out for:

Reaction to the sedative: Some patients may experience problems with their breathing, heart rate, and blood pressure.
Pancreatitis: This is inflammation caused by the x-ray dye or the ERCP probe. It is characterised by pain in the abdomen that continues to get worse after the procedure. This is rare and will need further management in hospital.
Bleeding: Some bleeding might occur and may need further treatment.
Sore throat: Due to the endoscope being inserted through the mouth, this should resolve in a few hours.
Nausea: Nausea may occurs as a reaction from the anaesthesia, this should get better after a few hours.
Abdominal pain: You might experience some mild abdominal discomfort after the procedure which should subside on its own.

What are the benefits of ERCP?

Minimally invasive
Used for identifying and diagnosing various issues in the bile and pancreatic ducts
Usually a short out-patient procedure
Able to insert stents or widen constrictions if necessary
Able to remove samples for biopsy purposes

Frequently asked questions

How long does an ERCP procedure take?

The whole procedure should last approximately 1 hours.

Is ERCP considered a surgery?

No, it is a minimally invasive procedure but it does involve minor cutting.

Is ERCP a painful procedure?

No, you will be under anaesthesia so you will not feel any pain.

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General

Liver

Oesophagus

Biliary/Pancreas

Stomach/Duodenum

Intestinal