What is an ERCP?Stomach
An ERCP (endoscopic retrograde cholangiopancreatography) is a specialized endoscopic technique used to visualize the drainage ducts of the gallbladder, pancreas and liver.  A small diameter endoscope is passed through the mouth, esophagus, stomach, and into the first part of the small intestine (duodenum).  A very small plastic tube (catheter) is inserted through the scope and into the opening of the bile ducts.  Dye is injected through the catheter and x-rays are taken. 

Do I really need an ERCP?
ERCP is often times necessary to diagnosis diseases some diseases of the liver, gallbladder or pancreas.  It can provide information used to determine whether or not surgery is necessary.  In many cases gallstones that have become lodged in the bile duct can be removed during ERCP, avoiding surgery. 

What preparation is required?
Do not eat or drink anything after midnight on the day before your test.  If you take a blood thinning medication, coumadin or aspirin, do not take it for 5 days prior to your exam.  Please inform the doctor if you have any allergies to drugs before your test, or if you are allergic to iodine or shellfish.  A companion must accompany you to the examination because you will be given medication to help you relax.  It will make you drowsy, so you will need someone to drive you home.  You will not be able to drive after the procedure.  Even though you may not feel tired, your judgment and reflexes may not be normal.  Please bring any x-rays with you, if requested.  Plan on arriving at the hospital one hour before your test is scheduled.

What should I expect during the procedure?
Your doctor will give you medication through a vein to make you relaxed and sleepy.  While you are lying on your stomach, the endoscope is inserted through the mouth, esophagus, stomach and into the duodenum.  X-rays will be taken after dye is injected into the bile ducts.   The procedure is extremely well tolerated with little or no discomfort.   The scope will not interfere with your breathing.  Gagging is usually prevented by the medication.  The procedure usually lasts five to fifteen minutes. 
What happens after the test?
You will be kept in the recovery area until most of the effects of the medication have worn off.  If any evidence of complications is observed you may be hospitalized for further observation.  Your throat may be a little sore for a couple of hours and you may feel bloated for a short time because of the air that was introduced to examine your stomach.  You will be able to resume your normal diet after the ERCP unless otherwise instructed.  You will be given appropriate discharge instructions and learning material before you go home.  You should make arrangements in advance to have someone stay at your home with you for the day.

Are there any complications from ERCP?
ERCP is usually well tolerated when performed by physicians who have been specially trained in this specialized procedure.  Major complications requiring hospitalization can occur but are rare.  Possible complications include pancreatitis, infection, bowel perforation and bleeding.  These complications occur in less than 1% of patients who undergo diagnostic ERCP. Localized irritation of the vein may occur at the site of medication injection.  A tender lump develops which may remain several weeks to months but goes away eventually.  Other risks include drug reactions, reaction to the dye and complications from unrelated diseases such as heart attack or stroke.

When will I know what my test showed?
Dr. Hasan will talk to you or the person accompanying your before you leave the endoscopy department and  preliminary results can usually be given to you at that time.  If a biopsy was taken, the results will not be received from the laboratory for 3 to 4 days. 


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