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Endoscopic Retrograde Cholangiopancreatography

We offer Endoscopic Retrograde Cholangiopancreatography at both our Credit Valley Hospital and Mississauga Hospital locations.

Endoscopic Retrograde Cholangiopancreatography combines endoscopy and x-ray. It is a test where a doctor passes a thin, flexible tube called a scope with a tiny camera attached to it through your mouth and into to your esophagus, stomach and duodenum (the first part of the small intestine). This procedure allows the doctor to:

  • take an x-ray of the insides of your bile ducts and pancreatic ducts

Endoscopic Retrograde Cholangiopancreatography can be used to diagnose and treat:

  • abnormalities in your pancreas, bile ducts, and gallbladder
  • blockages in your pancreatic and bile ducts


A referral from a doctor is required.​​

Resources for Patients & Their Families

How to Prepare for an Endoscopic Retrograde Cholangiopancreatography
Do not have anything to eat or drink after midnight the evening before the test. You need to have an empty stomach. Your doctor will give you precise instructions about how to prepare.

Tell your doctor about medications you’re taking, particularly aspirin products, arthritis medications, anticoagulants (blood thinners, such as warfarin or heparin), clopidogrel or insulin. You should also talk to your doctor about any allergies you have to medications or to intravenous contrast material (dye). Although an allergy doesn’t prevent you from having the procedure, it’s important to discuss it with your doctor beforehand, in case you need specific allergy medications before the test.

Also, be sure to tell your doctor if you have heart or lung conditions or other major diseases.

What to Expect During an Endoscopic Retrograde Cholangiopancreatography
During this procedure, you will lie on your front on an X-ray table and your doctor will pass an endoscope through your mouth, esophagus and stomach into your duodenum (the first part of your small intestine). An endoscope is a thin, flexible tube that lets your doctor see inside your bowels. After your doctor sees the common opening to the ducts from the liver and pancreas, called the major duodenal papilla, your doctor will pass a narrow plastic tube called a catheter through the endoscope and into the ducts.
The instrument does not interfere with breathing, but you might feel a bloating sensation because of the air introduced through the instrument.

Your doctor will inject a dye into your pancreatic or biliary ducts and will take X-rays. Your doctor might apply a local anesthetic to your throat and/or give you a sedative to make you more comfortable. Your doctor might even ask an anesthesiologist to administer sedation if your procedure is complex or expected to take a long time. Some patients also receive antibiotics before the procedure.

Are There Any Possible Complications?

Complications requiring hospitalization can occur, but they are uncommon. Complications can include pancreatitis (inflammation of the pancreas), infections, bowel perforation and bleeding. Some patients can have an adverse reaction to the sedative used.

Risks vary, depending on why the test is performed, what is found during the procedure, what therapeutic intervention is undertaken, and whether a patient has major medical problems.

Patients who are have the procedure as a treatment (such as for stone removal) face a higher risk of complications than patients having the test for diagnostic reasons. Your doctor will discuss your likelihood of complications before you have the test.

What Happens After Endoscopic Retrograde Cholangiopancreatography?
If you have Endoscopic Retrograde Cholangiopancreatography as an outpatient, you will be observed for complications until most of the effects of the medications have worn off before being sent home.

You might experience bloating or pass gas because of the air introduced during the examination.

You can resume your usual diet unless your doctor tells you something different.

Someone must accompany you home from the procedure because of the sedatives used during the examination. Even if you feel alert after the procedure, the sedatives can affect your judgment and reflexes for the rest of the day, making it unsafe to drive.