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Endoscopic retrograde cholangiopancreatography, or ERCP, is a specialised technique used to study the tubes that connect the gallbladder, pancreas and liver.

During ERCP, your doctor will pass an endoscope through your mouth, oesophagus and stomach into the duodenum (first part of the small intestine). After identifying the opening to the ducts, he or she will pass a narrow plastic tube through the camera and into the ducts. Then they will inject contrast material (dye) into the pancreatic or biliary ducts and will take X-rays. Most patients require some treatment during ERCP such as stone removal or plastic stents (tube) insertions to unblock the pipes.

You should fast for at least six hours (and preferably overnight) before the procedure. You should talk to your doctor about your regular medications and any allergies you have to medications, or intravenous contrast material. Also, be sure to tell your doctor if you have any other health issues.

The doctor might apply a local anaesthetic spray to your mouth and throat before giving you a sedative. Many patients receive antibiotics before the procedure, and an anti-inflammatory drug. You will lie on your abdomen on an X-ray table. You might feel a bloating sensation because of the air introduced through the instrument. Some patients experience some minor pain associated with this for a short time after the procedure.

This is a well-tolerated procedure when performed by doctors who are specially trained and experienced. Complications requiring hospitalisation occur in 1 in 20 patients. Risks vary, depending on why the test is performed, what is done during the procedure, and what other health problems you have.

Complications are usually minor and resolve within 2-3 days. Complications can include pain, infections (these can rarely be severe and life threatening), pancreatitis (an inflammation or infection of the pancreas) and bleeding.

It is very rare to have more severe complications such as perforation however if any symptoms develop please inform the doctor who performed your test to manage the problem immediately. Sometimes the procedure cannot be completed and may need an additional procedure.

Alfred Gastroenterology is a Gastroenterology practice in Newtown, located at the Royal Prince Alfred Hospital Health Campus in Sydney, Australia.