Know all about ERCP – Endoscopic Retrograde Cholangio-Pancreatography Procedure

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Know all about ERCP – Endoscopic Retrograde Cholangio-Pancreatography Procedure


What is ERCP?

ERCP - a procedure that permits gastroenterologist to ascertain the tiny tubes inside your body called the pancreatic and bile ducts. These tubes are near your stomach. They carry digestive juices from your liver and pancreas to the intestines.

For ERCP, your stomach specialist uses a versatile lighted tube called an “endoscope.” The endoscope, or scope, is about as thick as your index . It goes through your mouth into your stomach and therefore the first part of the tiny intestine, called the “duodenum.” Then the doctor puts a really small, flexible plastic tube through the scope and injects some dye. This procedure allows your doctor to see the ducts and how well they are working.

Why is ERCP done?

Gastro doctors do ERCP to seek out and treat problems within the duct and common bile duct. For example, you would possibly have ERCP if your gastro doctor suspects a disease of the pancreas or liver or a drag within the bile ducts. You might even have ERCP to seek out the explanation for abnormal results from a biopsy, ultrasound, or CT scan or to repair a drag that was identified on one of these tests. Finally, ERCP can help your doctor decide if you would like surgery and if so, which surgery is best.

The most common reasons for ERCP include:

  • Yellow skin or eyes (jaundice), light stool and dark urine
  • Stones in the bile or pancreas duct
  • A lesion or tumor within the pancreas, gallbladder, or liver

Your doctor might do ERCP before or after gallbladder surgery in specific situations. For example, they will find and take away gallstones from the common bile duct and sometimes from the pancreas. ERCP also can help find cancer or non-cancerous lesions. If your common bile duct is blocked, your doctor can use ERCP to place it during a small plastic tube called a “stent”. This keeps the duct open and digestive juices flowing. Finally, ERCP can help find and treat problems following gallbladder surgery.


Before the Procedure / Getting Ready for ERCP

ERCP is completed during a doctor’s office, clinic, or hospital. It is often done with sedation. You are not asleep during the procedure, but you're taking medicines called “sedatives” that cause you to relax and sleep.

Sometimes ERCP must be done under general anaesthesia, with you completely asleep. If you would like general anaesthesia, your doctor will discuss it with you. You might need a full physical examination. You might also need some tests to make sure you are healthy enough for surgery.

The surgeon who will do your ERCP will talk with you about the risks and benefits of the procedure. Then you'll sign a form saying you understand and comply with the procedure. Your surgeon’s office will tell you what to try and avoid before surgery. The exact instructions depend upon your surgeon, but here are some common things to try to do .

  • Stop eating and drinking at the time your doctor tells you before surgery
  • The morning of your surgery, you'll take medications your doctor told you're allowed. Take them with just a sip of water only
  • You might have to stop taking certain medicines before surgery. These include blood thinners, supplements, and medicines that affect your immune system. Talk to your surgeon when you schedule your medications
  • Tell your surgeon if you have a shellfish or iodine allergy

You will need someone to drive you home from the procedure. You may also need someone to remain with you overnight. Ask your doctor or nurse what proportion of assistance you might need.

Are there any alternatives to ERCP?

Occasionally, these problems are often addressed by radiology procedures or more advanced surgical procedures using cameras and tools by open or laparoscopic surgery, but ERCP is more commonly used because it is less invasive than surgery and it has a high rate of success.

What to Expect During the ERCP

A nurse may spray your throat with an area anesthetic before the test begins. This will numb your throat to keep you from gagging (choking) and make you more comfortable. You will receive sedative medicine through an IV. If you would like general anaesthesia for an ERCP, you'll be completely asleep for the procedure.

You will be lying on a table for the procedure which allows x-rays to be taken. Your doctor puts the endoscope into your mouth. Then they pass it down your throat (esophagus) to the stomach and therefore the first part of your intestine , the duodenum. The endoscope doesn't affect your breathing, and you would possibly even nod off during the procedure. If you are feeling discomfort, it'll probably be minor. For example, you would possibly feel slightly bloated from the air your doctor uses to inflate the duodenum. You might also feel minor discomfort when your doctor injects dye for the x-rays.

ERCP usually lasts thirty minutes to an hour. Your procedure might take more or less time counting on what your doctor must learn and do. You can talk with your doctor ahead of time about how long it might take.

What Happens after ERCP?

You stay in the procedure area for one (1) or 2 hours after your ERCP, until the sedatives wear off. Then you can have someone drive you home. You will probably want to spend the remainder of the day relaxing. You may eat normally and take your regular medicines after the procedure, unless your doctor tells you not to. You might have a sore throat for a day or two. You might need to spend the night in the hospital after the procedure. If so, your doctor will discuss it with you.

When will I get my ERCP results?

Your doctor will usually tell you the ERCP results on the day of the procedure. It might take several days to urge all the knowledge if your doctor took a little sample of tissue, called a biopsy. These results take longer because a laboratory must examine and test the tissue. Ask your doctor about the simplest thanks to learn your biopsy results.

Possible ERCP complications

ERCP is safe when your doctor has had specific training and is experienced at doing this specialized procedure. Problems, also called complications, can happen with any procedure. They are rare with ERCP, but they'll include the issues listed during this section.

The most common problem after ERCP may be a condition called “pancreatitis.” This happens when the duct to the pancreas is irritated by the X-ray dye or small plastic tube utilized in ERCP. This can cause abdominal pain that gets worse rather than better after the procedure.

Other problems are possible if your doctor did any treatment during your ERCP, like removing stones or fixing a little drain called a stent. These treatments have a little risk of causing bleeding or making a hole within the intestine or common bile duct . Rarely, people that have bleeding after the procedure may have a transfusion to exchange the lost blood, but this is often rare. Another very rare risk is the risk of infection transmission from scopes.

It is important for you to understand the first signs of possible complications. Call your doctor’s office immediately if you've got any of the issues below after ERCP.

  • Severe belly pain
  • Fever
  • Chills
  • Vomiting
  • Blood in your stool

Dr Chirayu Chokshi, Dr. Dhaval Dave & Dr. Darshak Shah together carry an experience of 27 years in ERCP and Advanced Therapeutic ERCP. They have done more than 35000 endoscopy procedures With over 1000 ERCP procedures.

Dr. Chirayu Chokshi & team is an expert Endoscopist in Vadodara, Gujarat. For more information, visit our website or call us on 9081333897 / 9825795257 to book an appointment.

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