Endoscopic retrograde cholangiopancreatography, or ERCP procedure, is a medical technique involving radiography following an injection of radiopaque contrast material to examine a patient’s bile and pancreatic ducts. Although ERCP procedure is considered a relatively safe practice, there is an unlikely chance of death involving the procedure. As a result of this, there are ERCP procedure alternatives available to patients.

MRCP as an Alternative

One of these procedures is called magnetic resonance cholangiopancreatography, or MRCP. MRCP is a technique utilizing magnetic resonance imaging of both intrahepatic and extrahepatic bile ducts and pancreatic duct. MRCP is considered comparable to ERCP procedure as they are both common and useful imaging modalities of the biliary tree.

ERCP Procedure

An ERCP procedure is performed using an endoscope. An endoscope is a tube-shaped medical instrument with a light and video camera. The endoscope is used to send a video feed of the patient to the doctors. The endoscope is pushed down through the patient’s esophagus and stomach into the small intestine. The procedure also requires administration of contrast material for the imaging to work properly.

ERCP Procedure Side Effects

A problem associated with ERCP procedure is side effects from treatment. ERCP procedure side effects are not a severe risk but they occur in 1 to 5 percent of patients. For instance, the most common side effect from ERCP procedure is pancreatitis, or inflammation of the pancreas. Pancreatitis can be fairly serious since it can occur even with experienced physicians and usually requires one or two days of treatment from a hospital. Many other ERCP procedure side effects require hospital treatment and sometimes surgery.

Side effects from ERCP procedures include, but are not limited to:

  • Intestinal perforation
  • Drug reactions
  • Bleeding
  • Depressed breathing
  • Irregular heartbeat
  • Heart attack

MRCP Procedure

An MRCP involves the use of magnetic resonance imaging (MRI) for internal diagnostics on a patient. The procedure is non-invasive, unlike ERCP procedure, and involves a simple process of scanning the patient using magnetic and radio frequencies from an MRI. MRCP is used to examine parts of a patient’s abdominal section such as the gall bladder, pancreas, liver, and bile ducts.

MRCP has advantages and disadvantages over ERCP procedure. However, both procedures can be effective and useful in many different medical circumstances. Some of the main advantages of MRCP are that it is non-invasive and does not require the use of contrast material. This is good for elderly patients. MRCP is also advantageous for patients that are sensitive during medical procedures and patients that cannot have contrast material. The disadvantage to MRCP is that sometimes the image quality is not adequate for diagnosis.


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