What is ERCP?

ERCP is a specialized technique used to study the ducts (drainage routes) of the gallbladder, pancreas, and liver (the drainage channels from the liver are called bile ducts or billiard ducts). An endoscope (flexible thin tube that allows the physician to see inside the bowel) is passed through the mouth, esophagus, and stomach into the duodenum (first part of the small intestine). After the common opening to ducts from the liver and pancreas is visually identified, a catheter (narrow plastic tube) is passed through the endoscope into the ducts. Contrast material (“dye”) is then injected gently into the ducts (pancreatic or biliary) and x-ray films are taken.

Prep Instructions for Upper Endoscopy, Dilation, PEG or ERCP

Arrive at the Endoscopy Center at the Winchester Medical Center, Medical Office Building #2, Suite 100, mall level for your procedure that is scheduled.

The Blue Ridge Endoscopy center is located on the first floor of MOB II Ste. 150, Phone (540)536-0345 Signs will direct you to Blue Ridge Endoscopy on the Mall Level. Do not go to our office on the 3rd floor. You are to arrive one hour in advance of the scheduled procedure time to allow for administrative check in and final procedure preparation. Procedure times are approximate and even though we intend to start on time there can be delays and we ask for your patience. On average you will be in the unit approximately 2-3 hours. Most procedures take 15 minutes and recovery from the sedation takes 45-60 minutes. Written discharge instructions will be given to you. You should take it easy after discharge until all the drug effects have worn off. Any diet instructions will be discussed with you prior to discharge. Any other special needs (like work slips), should be discussed prior to discharge with the nurse or physician. You will not be allowed to drive yourself home because of the sedation used.


Your diet should be restricted for this procedure to allow for optimal visualization of your gastrointestinal tract. You may drink clear liquids in limited quantities up to 4 hours before the procedure. NO SOLIDS DAY OF PROCEDURE. DAY OF PROCEDURE Clear liquids only - no fatty liquids (no cream, no milk, no solids).


You may take your usual medications with a small amount of water no later than 2 hours before the scheduled procedure time. Diabetes medications are usually held or reduced to half strength before these procedures because your food intake is being restricted. This should be discussed at the time the procedure is scheduled. Your medications can usually be restarted immediately after the procedure.


Aspirin, Plavix, and Coumadin should not be stopped for routine upper endoscopy. They are usually stopped for esophageal dilations and variceal banding. Patients having these procedures should discuss how to handle the blood thinners at the time the procedure is scheduled. Patients who cannot stop blood thinners because of the high risk of stroke should discuss any changes of blood thinners with your doctor.

Antibiotics are no longer required for routine endoscopic procedures.

***Insurance: If a pre-certification is required, you must call your insurance company immediately. Authorization may take a period of time. If additional information is requested from the insurance company, advise them to contact our office. At blue ridge we may use an anesthesiologist for sedation, which could incure an additional cost/bill. Please contact our office if you choose not to use an anesthesiologist for sedation. If please contact our office for a different sedation. If you do not have insurance, please call our office at (540) 667-1244 to make payment arrangements.***