Endoscopic Retrograde Cholangiopancreatography (ERCP)

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a specialized procedure used to diagnose and treat conditions affecting the bile ducts, pancreatic ducts, and gallbladder. It combines endoscopy and X-ray imaging for precise evaluation and intervention.

When Do I Need the Procedure

You might need Endoscopic Retrograde Cholangiopancreatography (ERCP) if you have symptoms or conditions related to the bile ducts, pancreatic ducts, or gallbladder. Here are common scenarios:

1. Blockages: If gallstones or tumours are obstructing the bile or pancreatic ducts, ERCP can help diagnose and treat the issue.
2. Narrowing (Strictures): ERCP is used to widen ducts that have become narrowed due to scar tissue or inflammation.
3. Bile Leaks: If bile is leaking from the ducts, ERCP can help locate and repair the problem.
4. Pancreatitis: ERCP can address complications like gallstone pancreatitis.
5. Unexplained Symptoms: Persistent upper abdominal pain, jaundice, or abnormal imaging results may warrant an ERCP.

What Do I Expect

During Endoscopic Retrograde Cholangiopancreatography (ERCP), here’s what you can expect:

Preparation

• You may need to fast for several hours before the procedure.
• Sedation or anaesthesia will be administered to ensure comfort.

Procedure

• A flexible endoscope with a camera is inserted through your mouth and guided into your small intestine.
• Contrast dye is injected into the ducts to make them visible on X-rays.
• The doctor may perform treatments during the procedure, such as removing gallstones or  placing stents.
• The procedure typically takes 30–60 minutes.

Post-Procedure

• You’ll be monitored for a short time to ensure there are no immediate complications.
• Mild throat soreness or bloating is common but temporary.
• You may need follow-up appointments to monitor for recurrence or additional treatment.

After the Procedure

After Endoscopic Retrograde Cholangiopancreatography (ERCP), proper aftercare is essential for recovery and to prevent complications. Here are some key guidelines:

Immediate Post-Procedure Care

• Rest & Recovery: You may feel drowsy due to sedation, so rest for at least 24 hours.
• Dietary Adjustments: Start with clear fluidsand gradually transition to soft foods. Avoid spicy, acidic, or greasy foods.

Common Side Effects

• Sore Throat: This is normal and should resolve in a few days. Gargling with warm salt water may help.
• Abdominal Bloating: This occurs due to air introduced during the procedure and should subside naturally.
• Drowsiness: Avoid driving or operating machinery for 24 hours.

When to Seek Medical Help

• Severe Abdominal Pain: Persistent pain may indicate complications.
• Vomiting Blood or Black Stools: This could signal bleeding and requires immediate medical attention.
• Fever Above 38°C: This may indicate infection.

Safety of the Procedure

Endoscopic Retrograde Cholangiopancreatography (ERCP) is generally considered a safe. However, like any medical procedure, it carries some risks.

Potential Risks

• Pancreatitis: Which can range from mild to severe.
• Infection: Rare, but possible, especially in the obstructed bile ducts.
• Bleeding: Bleeding may occur at the site of intervention.
• Perforation: Rarely, the endoscope can cause a tear in the digestive tract.

Benefits

• Minimally Invasive: No major surgery is required.
• Effective Diagnosis and Treatment: Helps identify and address blockages, gallstones, or leaks.
• Quick Recovery: Most patients resume normal activities within a day or two.

Cost of the Procedure

• Endoscopic Retrograde Cholangiopancreatography (ERCP) is a hospital procedure, it is covered under most hospitalization plans.
• The procedure is also Medisave deductible. Most of the companies’ health benefits and private health insurances cover the cost of the procedure, which may extend to the private hospitals.
• The fee benchmarks on the procedure done in different hospitals can be found in the website of Ministry of Health Singapore.
• Before the endoscopic procedure, a detailed financial counselling will be done to help the patients understand the cost breakdown in the preferred hospital.
• Patients should also check with their insurance provider on the updated policy regulations before the procedure.