What is the purpose of an ERCP?
An Endoscopic Retrograde Cholangiopancreatography ,or ERCP, is an endoscopic procedure used to shoot dye into the bile and pancreas ducts. X-ray pictures are taken afterward.
- ERCP can see if there is a blockage or narrowing in your bilary or pancreatic ducts caused by stones, tumors, or scarring.
- ERCP is frequently performed to find the cause of abnormal liver-chemistry tests and to follow up an abnormal ultrasound, CT scan, or MRI exam.
- During an ERCP, if any blocks are found, tools can be passed through to relieve a block.
- ERCP can help find the cause of pancreatitis, inflammation of the pancreas, and even to prevent future attacks.
- ERCP can relieve Jaundice caused by blocked bile ducts.
- ERCP may help you avoid surgery in some cases.
To properly prepare for your procedure, you may need to make certain changes to your daily medication routine.
- If you take insulin, consult with your physician about making any necessary changes in your daily regimen.
- If you take medications that contain aspirin or other anti-inflammatory drugs (such as Motrin, Advil, Indocin), we recommend that you stop taking them 7 days before your procedure. They may increase your risk of bleeding after removal of a polyp or a biopsy during your ERCP by interfering with the normal clotting or your blood.
- If you are currently taking Coumadin, Xarelto, Plavix, Eliquis or any other blood thinner, you must check with your prescribing physician before changing or interrupting your daily routine.
- Certain medications should be continued prior to your ERCP. If you take cardiac (heart) or anti-hypertensive (high blood pressure) pills, take them as you normally do with small sips of water.
- Bring a list of all your medications (prescription medications, over-the-counter medications and eye drops) with you on the day of your procedure. You may bring the medication bottles themselves.
- Be prepared to list and describe your allergies and reactions to any medications.
- Because you will receive a relaxing medication during your procedure, you must arrange to have a responsible adult pick you up and'or accompany you home if you will take public transportation. You may not operate an automobile or other mechanical equipment until the day following your procedure.
- To ensure the most accurate results possible, it is important that you do not eat or drink anything after midnight on the day before your procedure. The exception is medication taken with small sips of water.
The Day of Your Procedure
On the day of your ERCP plan to spend several hours at the unit to allow time for your preparation, procedure, and recovery.
Once in the exam room, you will be asked to lie on your abdomen on the stretcher. The IV sedation will be started. Once an adequate level of sedation is achieved, the endoscope will be gently inserted into the mouth. The scope will be carefully advanced through the esophagus, stomach, and small intestine to the position where the bile duct and pancreatic duct open into the small intestine. A small amount of air is injected through the scope into the gastrointestinal (GI) tract to help the physician see. In this exam, contrast is injected into the bile duct and pancreatic duct to see if there are any abnormalities. Depending on the findings of the exam, several things can be done at the time of the procedure including biopsies, sphincterotomy (cutting open the bile duct or pancreatic duct), removal of gallstones from the bile ducts or stones from the pancreatic ducts, or placement of stents (plastic/metal tubes) into the bile duct or pancreatic duct. Depending on the findings, the exam takes approximately 30 to 90 minutes.
After the ERCP, you will be taken to the recovery area where you will be monitored until most of the effects of the relaxing medication have worn off. You may have some cramping or bloating as a result of the procedure. Antibiotics may be required following an ERCP. Your physician will discuss this with you at the time of your procedure. Occasionally, patients will need to stay in the hospital overnight for monitoring.
You will not be allowed to drive for the rest of the day; therefore, you will need to arrange for a ride home. You will also be instructed not to work, sign important papers, or perform strenuous activities for the rest of the day. Most patients are able to eat and drink normally after their discharge from the Endoscopy unit; however, specific instructions regarding activity, eating, and medications will be given to the patient prior to discharge.
You should call the office at (714) 778-1300 to schedule a follow-up appointment within 2 weeks of your procedure. The results of the procedure and the follow-up plan will be discussed at the follow-up visit.