If you would like to speak to a nurse regarding your procedure or preparation, or if you need to reschedule your procedure, please call the appropriate number:

These instructions apply to patients scheduled for procedures at the Perelman Center for Advanced Medicine, Penn Presbyterian Medical Center and Penn Medicine Radnor. However, your doctor may give you different instructions or procedures. If you have questions about your procedure, contact your physician at the Digestive & Liver Center.

What is Endoscopic Retrograde Cholangiopancreatography

Endoscopic Retrograde Cholangiopancreatography (ERCP) is an examination of the pancreas, bile ducts, liver, and gallbladder for diseases. ERCP allows your physician to perform necessary treatments, such as enlarging a bile duct opening, removing gallstones lodged in the bile duct, inserting a stent (drain) in the duct or taking a biopsy specimen (tiny bit of tissue). 

What To Expect

Medications, Vitamins and Supplements

To properly prepare for your procedure, you may need to make certain changes to your daily medication routine.

  • If you take insulin, consult with your physician about making any necessary changes in you daily regimen.
  • If you take medications that contain aspirin or other anti-inflammatory drugs (such as Motrin, Advil, Indocin, or Feldene), we recommend that you stop taking them seven days before your procedure. They may increase your risk of bleeding after removal of a polyp or a biopsy during your ERCP by interfering with the normal clotting of your blood.
  • If you are currently taking Coumadin or Heparin, you must check with your prescribing physician before changing or interrupting your daily routine.
  • Certain medications should be continued prior to your ERCP. If you take cardiac (heart) or anti-hypertensive (high blood pressure) pills, take them as you normally do with small sips of water.

In addition to changes to your medication

  • Bring a list of all your medications (prescription medications, over-the-counter medications and eye drops) with you on the day of your procedure. You may bring the medication bottles themselves.
  • Be prepared to list and describe your allergies and reactions to any medications.

Because you will receive a relaxing medication during your procedure, you must arrange to have a responsible adult pick you up and/or accompany you home if you taking public transportation. You may not operate an automobile or other mechanical equipment until the day following your procedure.

On the Day Before Your Procedure

To ensure the most accurate results possible, it is important that you do not eat or drink anything after midnight on the day before your procedure. The exception is medication taken with small sips of water.

On the Day of Your Procedure

On the day of your ERCP, please come directly to the requested location at your scheduled arrival time and check in with the receptionist. Plan to spend several hours at the unit to allow time for your preparation, your procedure, and your recovery.

Before the procedure, a nurse will greet you and assist you with changing into a hospital gown. An IV will be placed in your arm. You will receive relaxing medications through the IV during the procedure. The duodenoscope will be passed through the mouth, esophagus, and stomach into the duodenum (first part of the small intestine). The physician will view the ducts by X-ray.

After your Procedure

After the ERCP, you will be taken to the recovery area where you will be monitored until most of the effects of the relaxing medication have worn off. If certain therapeutic procedures are performed, you physician may recommend observation overnight in the hospital.

You may have some cramping or bloating as a result of the air placed into your stomach during the procedure.

The Endoscopist will discuss the results of your procedure with you prior to your discharge. You will receive discharge instructions on the day of the test.

Your endoscopy report and biopsy results will be sent to your referring physician.

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