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What is Endoscopic retrograde cholangiopancreatography?

Endoscopic retrograde cholangiopancreatography is a minimally–invasive technique for examining and treating conditions affecting the liver, biliary system and pancreas.

ERCP is a specialised form of endoscopy. The London Clinic’s world-leading gastroenterologists use the procedure to diagnose and treat problems with the pancreatic and bile ducts, including blockages, stones and tumours.

The London Clinic provides ERCP in a private, comfortable and calm environment. With high-tech equipment and care by an expert multidisciplinary team, our patients have given the unit a satisfaction rate of between 98 and 100%.

Why choose The London Clinic?

The London Clinic is dedicated to providing the best, personalised healthcare with over 600 world-renowned consultants available to offer informed health advice and treatment. 

Spanning Harley Street and Devonshire Place, The London Clinic is situated in the heart of London’s internationally-known medical district. This central location, together with state-of-the art technologies and facilities that are not widely available in other hospitals, makes The London Clinic the hospital of choice for around 120,000 patients every year.

The London Clinic is an HTA licensed and JACIE accredited cancer centre with an ‘Excellent’ MacMillan Quality Environment Mark and with access to a Level 3 intensive care unit.

Offering affordable and competitive self-pay packages and expert support from Clinical Nurse Specialists and our specialised multidisciplinary team, over 98% of our patients said they would recommend The London Clinic to their friends and families.

Understanding your investigation

The London Clinic has a state-of-the-art Endoscopy Unit. As an independent, private clinic offering a Saturday service, we are dedicated to offering our patients the very latest investigations and greater flexibility and choice over when to access them.

The London Clinic has a team of expert consultant gastroenterologists and endoscopists who have extensive experience and skills. They will perform your ERCP and also take time to answer your questions and explain the results of the investigation. 

Why would I need a ERCP?

ERCP is performed to diagnose conditions affecting the liver, pancreas and gall bladder. It may be recommended if:

  • Potential problems have been identified on blood tests such as abnormal liver function tests 
  • Stones or blockages in the pancreatic or bile ducts have been seen on investigations like CT, ultrasound or MRI scans
  • You have become jaundiced 
  • You have unexplained pain in the upper abdomen, particularly on the right side

ERCP is more than an investigation, our gastroenterologists can also treat blockages of the bile and pancreatic ducts during the procedure. T

hese can be caused by gallstones, growths and cancers, or they can be due to spasm or scarring of a sphincter in the area. A thin tube called a stent can be inserted to help the bile and pancreatic juices flow, relieving jaundice and helping ease pain.

What is the preparation for ERCP?

Before the procedure, your consultant will arrange for blood tests to check that your blood count is normal and that it is clotting properly. To prepare for your ERCP, your consultant will usually ask you not to eat and drink on the day of the procedure. This will ensure that there are clear views of your digestive tract.

Our expert multi-disciplinary team will provide you with detailed guidance on what you can eat and drink prior to the ERCP. They will also advise on when to stop any blood-thinning mediations and whether to continue taking any medication you have been prescribed to control chronic conditions like diabetes and high blood pressure.

ERCP facts

Your consultant will perform the ERCP as an outpatient procedure. At The London Clinic, sedation and pain-relieving medication is administered into your vein before the procedure, to reduce discomfort and anxiety. Occasionally, your doctor may advise that the procedure is performed under general anaesthetic.

Your consultant may spray a local anaesthetic in your mouth, to numb your throat.

They will then insert the thin, flexible tube into your mouth. They may ask you to swallow, to help the endoscope pass down your throat. At this stage, you may feel a little pressure but there should be no pain and the sedation should make you feel pleasantly drowsy and relaxed.

The tube will be passed through the stomach and into the small intestine. There is a small camera on the end of the device, which relays high-quality images to a computer screen. Your consultant will inject dye into the bile ducts. This shows up on x-ray. They will be able to take detailed images of the bile and pancreatic ducts, which will highlight any blockages, stones and growths,

During the ERCP, your gastroenterologist can take biopsies or insert a stent to relieve any blockages. If there are gallstones, a small cut called a sphincterotomy may be made. This allows a special instrument to be inserted to open up any blockages and can also allow stones to drain away and be passed naturally.

An ERCP is a relatively short procedure, lasting from thirty minutes to over an hour, depending on the anatomy and the treatment required.

ERCP risks

There are risks with any procedure. Our gastroenterologists, together with our experienced nursing staff, work to minimise these and support your safe recovery

In some cases, you may simply have a mild sore throat after the procedure, however there is a small chance that you may experience a more significant complication:

  • Pancreatitis: Between one and two in fifty people may develop inflammation of the pancreas after the procedure. It usually starts within six to eight hours of the ERCP. It causes severe upper abdominal pain, which often goes through to the back and is relieved by leaning forward
  • Bleeding: This can be a problem if a sphincterotomy is performed. Around one on a hundred people bleed when a cut is made to the sphincter
  • Infection: Our consultants may give you a dose of antibiotics prior to the procedure, however between one in fifty and one in a hundred people that have a sphincerotomy will develop infected bile

ERCP recovery

After your ERCP, you will recover in our purpose-built unit until the sedation has worn off and you are alert and well. After the procedure, you might have some wind and cramping pain, this soon settles. Our nursing staff will support you and offer painkillers or a hot water-bottle.

Most complications become apparent within six hours, so our staff will keep a close eye on you during this time. Afterwards, you will need an escort to take you home and to stay with you overnight. You must avoid alcohol and shouldn’t drive, work or operate machinery for 24 hours, as you won’t be as mentally sharp as usual.

Your consultant will be able to discuss their visual findings as soon as you feel alert and able. They may then arrange an appointment to discuss the results of any biopsies and tests. Pathology laboratory results are usually available in 3 to 4 working days. They will explain your diagnosis, discuss your treatment options and address any worries that you have.

Treatment cost

The London Clinic offers affordable, competitive self-pay packages for certain treatments.

Patients have the option to spread the cost of treatment with Chrysalis Finance.

Please call +44 (0)20 3613 7502 to speak to our helpful team to find out more and to book an appointment.

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