Endoscopic Retrograde Cholangio-pancreatogrophy
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ERCP for Removal of a Stone in the Common Bile Duct
This informational video by the New England Journal of Medicine shows how ERCP is performed and how stones are removed from the bile duct.
Where can I find more information?
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Most medications can be continued as usual. Blood thinning medications, however, need to be stopped prior to ERCP. Ensure your surgeon knows which medications you take and that you have received specific advice about when to stop these medicineS, including: Aspirin, Plavix, Warfarin/coumadin, Xeralto and Pradax. Also, if you have any major diseases, such as heart or lung disease that may require special attention during the procedure, discuss this with your surgeon.
If you are coming from home, report to the X-Ray department at NRGH by 10 am. The staff there will give you further instructions. To make the examination comfortable, you will be sedated during the procedure, and, therefore, you will need someone to drive you home afterward. Sedatives will affect your judgment and reflexes for the rest of the day, so you should not drive or operate machinery until the next day. What Can Be Expected During The ERCP? Your throat will be sprayed with a local anesthetic before the test begins to numb your throat and prevent gagging. You will be given medication intravenously to help you relax during the examination. While you are lying in a comfortable position on an x-ray table, an endoscope will be gently passed through your mouth, down your esophagus, and into your stomach and duodenum. The procedure usually lasts about an hour. The endoscope does not interfere with your breathing. Most patients fall asleep during the procedure or find it only slightly uncomfortable. You may feel temporarily bloated during and after the procedure due to the air used to inflate the duodenum. As X-ray contrast material is injected into the pancreatic or bile ducts, you may feel some minor discomfort. |
What Happens After ERCP?
You will be monitored in the x-ray area for 1-2 hours until the effects of the sedatives have worn off. Your throat may be a little sore for a day or two. You will be able to resume your diet and take your routine medication after you leave the endoscopy area, unless otherwise instructed. Your surgeon will usually inform you of your test results on the day of the procedure. Biopsy results take several days to return, and you should make arrangements with your surgeon to get these results. The effects of sedation may make you forget what you were instructed after the procedure. Call your surgeon’s office for the results. What Complications Can Occur? ERCP is safe when performed by physicians who have had specific training and are experienced in this specialized endoscopic procedure. Complications are rare, however they can occur. Pancreatitis due to irritation of the pancreatic duct by the X-ray contrast material or guidewire is the most common complication, occurring in less than 5% of cases. Other serious complications such as a perforation of the bowel or significant bleeding is rare, and occur once or twice in a hundred cases. A reaction to the sedatives can occur. Irritation to the vein in which medications were given is uncommon, but may cause a tender lump lasting a few weeks. Warm moist towels will help relieve this discomfort. It is important for you to recognize the early signs of possible complications and to contact your surgeon if you notice symptoms of severe abdominal pain, fever, chills, vomiting, or rectal bleeding. |