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ERCP test

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This page tells you about a test called endoscopic retrograde cholangio pancreatography (ERCP). You can find the following information


A quick guide to what’s on this page

What is an ERCP?

An ERCP stands for endoscopic retrograde cholangio pancreatography. It can diagnose conditions of the liver, bile ducts, pancreas or gallbladder. A doctor or nurse passes a tube called an endoscope down your throat to take X-rays.

The endoscope is very flexible and has a small camera and light at the end. Through the endoscope, the doctor or nurse can see any growths or other abnormal looking areas. They can also take samples (biopsies) of any abnormal areas. The test takes between 30 minutes and an hour.

Having an ERCP

You can have the test as an outpatient. You shouldn’t eat for about 6 to 8 hours beforehand. You may be allowed sips of water for up to 2 hours before.You may need to change into a gown.

To have the test you lie on an X-ray couch. A doctor or nurse puts a small tube (cannula) into a vein in your arm. Through this they give you a drug to make you very drowsy, antibiotics to prevent infection, and fluids (drip).

Your doctor passes the endoscope down your throat into your stomach and small bowel. They inject dyes into the channels (ducts) of the bile ducts and pancreas to make them show up on X-rays. After the test you need to rest for a while. You can usually go home the same day. You will need someone to take you home and stay with you overnight.

There is a risk of inflammation of the pancreas (pancreatitis), infection, bleeding and a hole in the small bowel (perforation). Contact the hospital if you get a temperature or feel generally unwell after the test.

The results

It can take up to a couple of weeks to get the results. Contact your doctor's secretary or specialist nurse if you haven’t heard from the hospital after this time.


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What an ERCP is

ERCP stands for endoscopic retrograde cholangio pancreatography. Doctors use this test to diagnose conditions of the liver, bile ducts, pancreas and gallbladder. They pass a tube called an endoscope down your throat to take X-rays of the pancreas and gallbladder. The endoscope is a long flexible tube with a small camera and light at the end.

The doctor can look down the endoscope, or at pictures on a TV monitor, and see if there are any growths or other abnormal looking areas in the pancreas or gallbladder. They can take samples (biopsies) of any abnormal looking areas. The test takes between 30 minutes and an hour.

Doctors may also use ERCP to give treatment. For example, to put a plastic or metal tube (stent) into the bile or pancreatic duct to clear a blockage.


Before an ERCP

About 2 days before the ERCP you usually have a blood test to check how well your blood clots. If you are taking any medicines that change how your blood clots, it is very important to let your doctor know. These medicines include aspirin, arthritis medicines and warfarin (Coumadin). You may need to stop taking these medicines a number of days before the ERCP. Your doctor will give you advice about this.

You can have an ERCP test as an outpatient. You can't eat for about 6 to 8 hours before the test so that your stomach and small bowel (duodenum) are empty. You may be allowed to drink sips of water up to 2 hours before. Your doctor will give you written instructions about this beforehand, or the instructions may arrive with your appointment letter.

When you get to the clinic, the nurse may ask you to take your upper clothing off and put on a hospital gown. Once you are ready, you get onto the bed or X-ray couch.

When you are lying on the couch, the nurse may put a drip (intravenous infusion) into the back of one of your hands. You may have antibiotics through the drip, to prevent infection. You may also have fluids through the drip during the ERCP. You usually have an injection of sedation first to make you very drowsy. Your doctor may spray the back of your throat with local anaesthetic to make it easier to swallow the endoscopy tube.

You will need to take someone with you to the hospital appointment. You won't be able to drive for the rest of the day and should have someone to go home with you and stay overnight.


During the ERCP test

Once the sedative has worked, the doctor passes the endoscope tube gently down your throat to the area where the pancreas and bile ducts join the small bowel (duodenum). Your doctor will ask you to swallow as the tube goes down. You will be able to breathe normally. Your nurse will check your pulse and oxygen levels throughout the test. You will have oxygen through a tube that fits into your nose (nasal cannulae).

Through the endoscope, your doctor can see the inside of your stomach and small bowel. They may put a small amount of air into the small bowel to help them see more clearly. They then inject dyes into the channels (ducts) in the biliary tree and pancreas so they can see them on X-rays. If there are any abnormal areas, the doctor will take pieces of tissue (biopsies) to send to the laboratory for examination under a microscope.

When the test is over you will need to rest for a while and may need to stay in the department for a few hours. If you've had a sedative, you may not remember much (if anything) about the test once you have come round. You should be able to go home the same day.


Possible problems with ERCP

Having an ERCP helps doctors find out what may be causing your symptoms. Most people do not have problems following the test, but as with any medical procedure, there are possible risks. Doctors make sure the benefits of the test outweigh these risks.

The main side effect is bloating and discomfort in your tummy (abdomen) due to the air that the doctor puts into your small bowel during the test. This soon disappears. You may have tenderness or a lump in your hand where you had the sedative injection. But this should go away in a few days.

Possible problems after ERCP include pancreatitis (inflammation of the pancreas), infection, bleeding, and a hole (perforation) in the duodenum. Pancreatitis can happen in up to 1 in 10 people but the other problems are very uncommon.

If you have persistent or severe pain in your abdomen, a high temperature, jaundice, or signs of bleeding, you should contact the hospital where you had the ERCP or go to A&E (accident and emergency). Your nurse will give you details of who to ring if you have any problems at home.


The results

It can take time for test results to come through. How long will depend on why you are having the test but it may be a couple of weeks. Usually, the doctor who does the ERCP writes a report straight way. The report is sent to your specialist, who gives the results to you. If your GP has sent you for the test, the results will go directly to the GP surgery.

Understandably, waiting for results can make you anxious. If your doctor needs the results urgently, they can make a note of this on the request form and they will be ready sooner. Try to remember to ask your doctor how long you should expect to wait for the results when you are first asked to go for the test. If it is not an emergency, and you have not heard after a couple of weeks, ring your doctor's secretary or GP to check if they are back.

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Updated: 23 April 2015