Endoscopic Retrograde Cholangiopancreatography

Endoscopic Retrograde Cholangiopancreatography (ERCP)

An endoscopic retrograde cholangiopancreatography (ERCP) allows the doctor to see inside the esophagus (swallowing tube), stomach, and duodenum (beginning of the small intestine) as well as to examine the bile and pancreatic drainage tubes (ducts). The procedure involves placing a thin, flexible tube with a special camera (called an endoscope) through the mouth and into the stomach. Small catheters are used to inject dye into the ducts to determine if problems such as stones or strictures (narrowed areas) exist. Stones may be removed by cutting the muscle at the end of the bile duct (sphincterotomy) and stents may be placed across strictures. Very small samples (biopsies) may be taken from the areas being tested. Special instruments may also be used to stretch narrowed areas (dilation) or stop bleeding (cautery or injections).

Procedure Instructions

The procedure normally takes about 30 to 45 minutes. Medications are usually given just before the procedure to help you relax. The entire procedure is usually painless, and most people remember very little about the test.

Fortunately, complications are uncommon. The most common complications are pancreatitis (inflammation of the digestive gland behind the stomach), 1 in 12; perforation (tear) of the esophagus or stomach, 1 in 1,000; bleeding, 1 in 100; and heart or lung problems related to the sedative given, 1 in 5,000.

Preparation

1. You will receive specific preparation instructions for your procedure. Please read these instructions right away because you may need to make some medication and diet changes as early as one week before the procedure.
2. If you have any questions about your instructions, please call the GI Endoscopy office at 860-679-7595. If you have any questions or concerns regarding the preparation after 3 p.m., you can reach a GI doctor by calling the hospital operator at 860-679-2626 and ask to speak to the GI fellow on call.
3. Drink plenty of fluids throughout the day. It is important to stay hydrated.
4. Take your usual medications for blood pressure, heart problems, lung problems, and other chronic health conditions. Check with your physician or the GI Endoscopy office at 860-679-7595 if you are unsure whether to take or stop a medication.
5. Do not eat or drink anything after midnight on the night before the procedure. The only exceptions to this will be taking your medications with sips of water, or if your procedure is scheduled in the afternoon (you will be given specific instructions if this is the case).

Day of Procedure

1. Dress casually. Do not wear jewelry or bring any valuables with you.
2. Do not drive yourself. You must have someone drive you and remain here during your procedure. Public transportation is not acceptable unless you have someone to ride with you. Your procedure will be cancelled if you have not made arrangements for someone to accompany you and transport you home.
3. It is important for you to arrive on time.

After Your Procedure

1. You will be observed for approximately 30 minutes after your procedure.
2. It is not unusual to feel slightly dizzy or sleepy after receiving sedation for the procedure. You will not be able to drive, operate machinery, play sports, or make important decisions for the remainder of the day. It is highly recommended that someone stay with you for a few hours following the procedure.
3. You should be ready to go home approximately 2 to 3 hours after your arrival for the procedure.
4. Written information about the preliminary results of the test and follow-up instructions will be given to you prior to your discharge.
5. If you have any questions, please call the GI Endoscopy office at 860-679-7595 or 860-679-2626 after 3 p.m.

Important Notes

1. Follow your preparation instructions.
2. You need to arrive one hour prior to your procedure.
3. You must arrange for a ride home or your procedure will be rescheduled. (A taxi, bus, or limo is not acceptable unless you have someone to ride with you.)
4. Please have your ride available 30 minutes after your procedure.
5. Three to seven days before your procedure, you will receive a call to confirm your appointment. If you do not receive this call, please call 860-679-3238 to confirm.
6. If you need to cancel your appointment, please call at least seven days before your procedure.

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