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Using ECRP to Treat Diseases of the Digestive System

Therapeutic endoscopic retrograde cholangiopancreatography (ECRP) is a procedure used to diagnose and treat diseases of the gall bladder, liver, pancreas and biliary systems. It was first employed in the 1970s in the diagnosis of diseases in these organs, but currently it is also used for therapeutic purposes.

Benefits of Endoscopic Retrograde Cholangiopancreatography (ECRP)

Dr. Cofrancesco and Dr. Quijano together with the staff at GI North would like you to know that ERCP provides detailed and accurate information about the pancreaticobiliary system in cases where endoscopic ultrasound cannot be used. ERCP is also less invasive than open surgery for several pancreatic diseases. In addition, if a blockage is found in the bile duct that causes yellow jaundice, it can be relieved using sphincterotomy or stent placement.

Uses of Endoscopic Retrograde Cholangiopancreatography

Because of factors related to diet, heredity and environment, the pancreas, gall bladder and bile duct are prone to several disorders that can develop into a variety of diseases and symptoms. Physicians, therefore, use ERCP in the diagnosis and treatment of:

  • Blocked bile duct
  • Cancer of the pancreas and bile duct
  • Gallstones
  • Pancreatitis (inflamed pancreas)

Preparation for Endoscopic Retrograde Cholangiopancreatography

The only preparation that a patient is required to have is fasting for at least eight hours. Therefore, you are not supposed to eat or drink anything for this period before the procedure.

The Procedure

photo of young guy having stomach pain | GI North

Dr. Cofrancesco and Dr. Quijano and the staff at GI North use ERCP in the diagnosis and treatment of blocked bile duct, cancer of the pancreas and bile duct, gallstones, and pancreatitis which is also known as an inflamed pancreas.

The ERCP procedure is done using X-ray films, and thus it takes place in the X-ray room. The physician sedates patient and also gives analgesia. The patient lies on his or her left side, and the back of the throat is sprayed with a local anesthesia. The physician may also pump air into the duodenum to improve the visualization. An endoscope is then gently placed into the upper esophagus during which the patient breathes easily, and rarely gagging occurs. The physician inserts a tube through the endoscope to the main bile duct that enters the duodenum. Then dye is injected into the bile duct or pancreatic duct, and an X-ray film is then taken. These images show the obstruction area. If gallstones are found, steps are taken to remove them, and if any duct is narrowed, an incision can be made using electrical heat (electrocautery) to relieve the blockage. It is also possible to widen narrow canals and to insert small tubes to keep them open. The examination typically takes an average of 20 to 40 minutes and then the patient is then taken to the recovery area.


The doctor explains the ERCP results to the patient. If the effect of the sedative is prolonged, the physician may suggest to the patient a later appointment to help the patient understand the results of the examination.

Alternatives to Endoscopic Retrograde Cholangiopancreatography

There are several techniques that can substitute ERCP. These include:

    • Certain types of X-ray such as the CT and CAT scans
    • Sonography (ultrasound)
    • Magnetic Resonance Cholangiopancreatography (MRCP) to visualize the bile duct and pancreas

Possible Side Effects

There are several possible side effects to Therapeutic endoscopic retrograde cholangiopancreatography (ECRP). The patient may experience a temporary, mild sore throat, or may develop an inflammation of the pancreas. Serious risks such as excessive bleeding when electrocautery is done to open blocked ducts are rare. Also rare is a perforation or tear through the intestinal wall. Complications that may require the patient to be hospitalized may occur, but these rarely require surgery.

Because of the effect of the sedative, the patient is advised not to drive or operate machinery for the remaining part of the day after ERCP. Therefore, a driver should accompany the patient in case he or she drives to the physician’s office or clinic.

ERCP is performed on an outpatient basis while the patient is sedated. The procedure provides valuable information upon which treatment is based, and in certain cases, therapy can be administered through an endoscope. If you have any questions or need help with your medical condition, Dr. Cofrancesco and Dr. Quijano of GI North will be glad to assist you. Dr. Quijano speaks fluent Spanish. They serve the residents of Cumming, GA as well as the surrounding areas such as Alpharetta, Canton, Roswell, and Suwanee. Call (404) 446-0600 today to make an appointment.

© 2015 GI North Gastroenterology Services. All rights reserved.

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