A Biliary Endoscopy enables physicians to diagnose problems in the liver, gallbladder, bile ducts and pancreas.
The liver is a large organ that, among other things, makes a liquid called bile that helps with digestion. The gallbladder is a small, pear-shaped organ that stores bile until it is needed for digestion. The bile ducts are tubes that carry bile from the liver to the gallbladder and small intestine. These ducts are sometimes called the biliary tree. The pancreas is a large gland that produces chemicals that help with digestion and hormones, such as insulin.
Also known as Endoscopic Retrograde Cholangiopancreatography (ERCP), a Biliary Endoscopy is primarily used by physicians of the Digestive Disease Center to diagnose and treat the conditions of the bile ducts, including gallstones, inflammatory strictures (scars), leaks (from trauma and surgery) and cancer. It combines the use of x-rays and an endoscope, a long, flexible, lighted tube. Through the endoscope, the physician can see the inside of the stomach and duodenum and can inject dyes into the ducts in the biliary tree and pancreas, so they can be seen on x-rays.
What to Expect during a Biliary Endoscopy
During this procedure, you will lie on your left side on an examining table in an x-ray room. You will be given medication to help numb the back of your throat and a sedative to help you relax during the exam. You will swallow the endoscope, and the physician will then guide the scope through your esophagus, stomach and duodenum until it reaches the spot where the ducts of the biliary tree and pancreas open into the duodenum. At that time, you will be turned to lie flat on your stomach, and the physician will pass a small plastic tube through the scope. Through the tube, the physician will inject a dye into the ducts to make them show up clearly on x rays. X-rays are taken as soon as the dye is injected.
If the exam shows a gallstone or narrowing of the ducts, the physician can insert instruments into the scope to remove or relieve the obstruction. Also, tissue samples or a biopsy can be taken for further testing.
Possible complications of a Biliary Endoscopy or ERCP include pancreatitis (inflammation of the pancreas), infection, bleeding and perforation of the duodenum. Except for pancreatitis, such problems are uncommon. You may have tenderness or a lump where the sedative was injected for just a few days.
A Biliary Endoscopy can take anywhere from 30 minutes to 2 hours. You may have some discomfort when the physician blows air into the duodenum and injects the dye into the ducts. However, the pain medicine and sedative should keep you from feeling too much discomfort. After the procedure, you will need to stay at the hospital for 1 to 2 hours until the sedative wears off. The physician will make sure you do not have signs of complications before you leave. If any kind of treatment is done during the endoscopy (ERCP), such as the removal of a gallstone, you may need to stay in the hospital overnight.
Preparing for Biliary Endoscopy
Here at the Digestive Disease Center, we will provide you with all the information you need to know in order to prepare for a Biliary Endoscopy (ERCP), including written instructions. Your stomach and duodenum must be empty in order for the procedure to be accurate and safe. You will not be able to eat or drink anything after midnight the night before the procedure or for 6 to 8 hours beforehand, depending on the time of your procedure. Your physician will need to know whether you have any allergies, especially to iodine, which is in the dye. Driving is prohibited after this procedure until the sedatives wear off, so you must arrange for a ride home.