Why might this procedure be needed?

An endoscopic retrograde cholangiopancreatogram may be needed to diagnose and treat gallstones, inflammatory strictures (scars), leaks (from trauma and surgery) and to screen for cancer in the gallbladder, bile system, pancreas, and liver.

What does it involve?

For an ERCP (endoscopic retrograde cholangiopancreatography) you will be instructed to empty your stomach and bowels. Your gastroenterologist will instruct you to stop eating any food 8 hours prior and that you take a laxative to flush out your bowels before your procedure.

An endoscopic retrograde cholangiopancreatography is usually done in day theatre on an outpatient basis. This means you will not need general anaesthesia, but you will be given a sedative to relax you. While the procedure won't be painful, it may be a bit uncomfortable. You will be given an anaesthetic throat spray which will numb your throat. Dr Mokhele will begin by inserting a thin endoscope fitted with a camera into your mouth. You will then be asked to swallow the endoscope to allow it to move through the oesophagus, stomach and upper part of the small intestine. He will then identify where the bile duct is situated, and a tiny catheter is inserted into it. This catheter will then squirt a contrast agent which will allow your gastroenterologist to view the internal state of the bile system on x-ray images, and diagnose your condition.

If needed, tiny tools may be passed through the endoscope to perform surgery such as a stent placement or sphincterotomy which may help with drainage of the bile duct. Gallstones can also be removed endoscopically.

After the procedure, if you have had a sedative, you will need someone to drive you, and you will have to wait for it to wear off before you can go home. Otherwise, you can go home directly after the procedure. You may experience a mild sore throat, bloating, gas and cramping after an endoscopy procedure. While rare, symptoms such as severe abdominal pain, vomiting, nausea, blood in the stool, fever or chills are however not normal and may be an indication of a perforation or infection. If you experience any of these symptoms, it is important to contact your doctor immediately.