Endoscopic Retrograde Cholangiopancreatography (ERCP) What Is It? Endoscopic Retrograde Cholangiopancreatography (ERCP) is performed to diagnose diseases or other conditions of the pancreas, bile ducts, liver and gallbladder. A flexible tube is inserted into the mouth to examine the esophagus, stomach and duodenum. Contrast dye is injected which outlines the bile ducts and pancreas in order to take detailed x-rays of these areas. How Do I Prepare? Do not eat or drink anything after midnight the night before. Discuss with your doctor what medications you should take. If you are taking medication to thin your blood (e.g., Coumadin, Warfarin, Plavix, or aspirin), you should check with your doctor about stopping these medications before this test. Medications that your doctor has instructed you to take can be taken with a small amount of water. If you have had a reaction to contrast dye in the past, be sure to tell your physician. If you wear dentures, they must be removed for the procedure. Be sure to arrange transportation. Someone must stay with you at the hospital until discharge and drive you home. Transportation will be verified before the procedure. You may use a taxi cab for your transportation only if you have a person accompanying you other than the taxi cab driver. Your procedure may be cancelled if these arrangements are not made. What Happens During the Procedure? Consent is signed. Your stomach must be completely empty for the best and safest exam. An intravenous needle (IV) is inserted. The procedure is done in the x-ray department. You will be lying on your abdomen with your head turned to the right. Oxygen will be used throughout the procedure. Your blood pressure and pulse will be continuously monitored during the procedure. You will be given medication to make you sleepy and relaxed and to minimize discomfort. Depending on your doctor's preference, your throat may be sprayed with a local anesthetic to numb your gag reflex. A mouthpiece will be inserted and you will bite down on it with your teeth. The scope is then inserted and the examination is started. The procedure takes one hour or more. Recovery time is about 2 hours. Plan to be at the hospital for a minimum of 3 hours.