Endoscopic Retrograde Cholangiopancreatography (ERCP) & Endoscopic Ultrasound (EUS) at IGH

http://www.IndyGastro.com (EUS) Endoscopic Retrograde Cholangiopancreatography, or ERCP, is a specialized technique used to study the ducts of the gallbladder, pancreas, and liver. Ducts are drainage routes; the drainage channels from the liver are called bile or biliary ducts. If your doctor has recommended an ERCP, this page will give you a basic understanding of the procedure. If you have questions and concerns, please consult your doctor. During ERCP, your doctor passes an endoscope through your mouth, esophagus, and stomach into the duodenum, which is 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 ducts from the liver and pancreas, he passes a narrow plastic tube called a catheter through the endoscope and into the ducts. Your doctor injects a dye into the pancreatic or biliary ducts and takes X-rays with contrast. How Should I Prepare for My ECRP? Stop eating food and unapproved beverages by midnight the night before your endoscopy. You can drink clear liquids until five hours before to your scheduled endoscopy time. The following are approved clear liquids: water, apple juice, white grape juice, cranberry juice, broth, bouillon, tea, black or sweetened coffee, colas/sodas/carbonated beverages, Gatorade and other sports drinks, popsicles, and Jello. Patients scheduled to go under general anesthesia, including Propofol, must stop clear liquids earlier. Please refer to the specific instructions provided by your physician. What can I expect during ERCP? Your doctor may apply a local anesthetic to your throat or give you a sedative to make you more comfortable. Some patients receive antibiotics before the procedure. You will lie on your left side on an X-ray table. As the endoscope passes through your mouth, esophagus, stomach, and duodenum, it does not interfere with breathing. However, you may feel a bloating sensation because of the air introduced through the instrument. What are possible complications of ERCP? Patients tolerate ERCP well when doctors who are specially trained and experienced in the technique perform the procedure. Although complications requiring hospitalization can occur, they are uncommon. Complications can include pancreatitis (an inflammation or infection of the pancreas), infections, bowel perforation, and bleeding. Some patients have adverse reactions to the sedative used. Sometimes the procedure cannot be completed due to technical issues. 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 undergoing therapeutic ERCP for stone removal face a higher risk of complications than patients undergoing diagnostic ERCP. Your doctor will discuss your likelihood of complications before you undergo the test. What can I expect after ERCP? If you have ERCP as an outpatient, you will be observed for complications until most of the effects of the medications have worn off. You might experience bloating or pass gas because of the air introduced during the examination. You can resume your usual diet unless you are instructed otherwise. 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. Please contact your doctor promptly if you have any follow-up questions or if you are experiencing any complications due to the procedure.

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