This information is approved and/or reviewed by U-M Health System providers but it is not a tool for self-diagnosis or a substitute for medical treatment. You should speak to your physician or make an appointment to be seen if you have questions or concerns about this information or your medical condition.| Complete disclaimer
ERCP (Endoscopic Retrograde Cholangiopancreatography)
This guide is for patients who are going to have ERCP. It answers some of the most commonly asked questions. Please ask your doctor or nurse for more information.
What is ERCP?
ERCP is a visual examination of the interior of the pancreas and bile ducts using an instrument called an endoscope. ERCP is a valuable tool in the diagnosis and treatment of many diseases of the pancreas, bile ducts, liver, and gallbladder. During this visual examination, your doctor may perform other minor procedures that will benefit you, such as taking a small piece of tissue for biopsy. Please note that biopsies are taken for many reasons and do not necessarily imply cancer.
Having an ERCP will assist your doctor in making medical decisions and will also be beneficial in planning your overall medical care. The procedure takes about 90 minutes. However, you should expect your visit to last 3-4 hours to allow for preparation and recovery time.
Preparing for your ERCP
- Please contact your primary care physician or insurance company if prior referral is needed.
- If you are unable to keep your appointment, please call (888) 229-7408 or (734) 936-9250 (option 1) as soon as possible to reschedule.
- If you have an implanted cardiac defibrillator (ICD), please call the above number as soon as possible to report the ICD name and manufacturer prior to your procedure.
- Be sure to tell the doctor who ordered your ERCP if you are taking Coumadin or other blood thinners. You will need special instructions.
- Be sure to tell the doctor that ordered your test if you are allergic to contrast.
YOU MUST ARRANGE FOR A RESPONSIBLE ADULT (OVER 18) TO ACCOMPANY YOU from the endoscopy unit of your ERCP. This person must remain in the unit during your entire visit so that they are available as soon as you are ready to be discharged. YOU WILL NOT BE DISCHARGED unless that person is in the unit.
Because your judgment can be impaired after this procedure, YOU WILL NOT BE RELEASED to public transportation, a taxicab driver, or even to walk home without another responsible adult to accompany you.
One week (seven  days) before your ERCP
- Be sure to tell the doctor who ordered your test if you are taking Coumadin, warfarin, blood-thinners, or any of the anti-platelet medications. You may need special instructions.
Here are some names of common anti-platelets drugs:
- ReoPro (abciximab)
- Aggrenox (aspirin plus dipyridamole)
- Plavix (clopidogrel)
- Persantine (dipyridamole)
- Integrilin (eptifibatide)
- Ticlid (ticlopidine)
- Aggrastat (tirofiban)
- Do not take herbal supplements for one (1) week before your ERCP as some of these products may increase your risk of bleeding.
- If you are not sure if you should continue taking certain medications before your ERCP, please ask your health care professional.
The day before your ERCP
- You may eat your normal diet until midnight the day before the procedure.
- Do not eat any solid food for six (6) hours prior to your scheduled appointment time. No hard candy or chewing gum six (6) hours prior to your scheduled appointment time.
- You may drink clear liquids such as water or black coffee up to two (2) hours before the procedure.
- Take your medications with a few sips of water no later than four (4) hours before your appointment. If you are taking pain medication, you may do so up to four (4) hours before the procedure.
The day of your ERCP
- Your procedure is scheduled for:
Date:_______________ Time:__________ at the
University of Michigan Medical Procedures Unit, Room 2B 355.
- Please bring the following with you on the day of your ERCP:
1. A list of all medications you are taking
2. A list of any allergies you have
3. Health insurance cards
4. Your blue University of Michigan hospital card
5. A responsible adult must accompany you from the endoscopy suite after your procedure. Your procedure will not begin until the nursing staff speaks with the responsible adult who will take you home. You will not be discharged until that person is in the unit to escort you from the endoscopy suite.
- Please leave jewelry at home.
- Small children will be more comfortable at home.
- If you have diabetes and take insulin, on the morning of your test: Take ½ of your usual dose of long-acting insulin the morning of the test. Long-acting insulins include NPH, Humulin N, Humulin 70/30, Humalog Mix 75/25, Lantus, and Levemir. If you take Humulin R 500 insulin, take only ½ of your usual dose. Do not take short-acting insulin the morning of the test. Short-acting insulins include Regular, Humulin R, Novolin R. Take the other ½ of your long-acting insulin and any regularly scheduled dose of short-acting insulin right after the test. Be sure to eat your usual meal at that time. Please review the handout Instructions for Patients with Diabetes Having Outpatient Procedures/Tests, which the ordering physician will give you. You can find this handout online; click on this link Instructions for Patients with Diabetes Having Outpatient Procedures/Tests.
In the reception or preparation area you will answer questions about your health, current medicines, and allergies. You will sign a consent form. After you change into a hospital gown, a nurse will place an intravenous (IV) line in your arm to give you medication to make you more comfortable during the procedure. The procedure is performed in a room specially designed for endoscopic procedures. Equipment that will help the nurse and doctor monitor your heartbeat and breathing will be connected to you. Your throat will be numbed with a spray and you will be sedated before the doctor passes the tube through your mouth into your stomach. You will be able to breathe normally and burp if needed during the procedure.
During the procedure, you may feel some bloating or abdominal gas due to the air inserted during the procedure. X-rays will be taken throughout the procedure.
As the x-ray dye is injected, you may also feel some mild discomfort. These feelings, however, should not be painful. Every effort will be made to keep you as comfortable as possible during the test.
As with any medical procedure, there are potential complications associated with ERCP. These complications will be explained to you at the time you sign your consent for the procedure, if not before. If there are complications with your ERCP, it might require an overnight observational stay in the hospital. Just in case, we suggest you bring slippers and a robe with you and make alternative child care plans for the evening of your procedure.
A doctor specially trained in gastrointestinal procedures will perform the test. The doctor who ordered your procedure will make decisions regarding your plan of care.
After your procedure you will be taken to the recovery area. One adult person who came with you to your procedure may join you there, if you wish. When you are ready to go home the nurse will discuss discharge instructions and answer your questions. You will be given a summary of findings for your procedure. You may NOT drive yourself home. Be sure to bring a responsible adult licensed driver with you. A responsible adult will need to be with you when you are discharged from the recovery area. We suggest a family member or friend stay with you for the remainder of the day.
- You will be given specific written instructions about resuming your activity, medications, and diet.
- You may return to work or school the day after your test
- Do not drive a vehicle or operate machinery for at least 12 hours after your test.
- Do not make any major legal or financial decisions for at least 12 hours after your test.
- Do not drink alcoholic beverages for at least 12 hours following your procedure.
- If you have questions about your procedure, please contact your outpatient nurse at 734-_________________.