ERCP
The Procedure
ERCP (Endoscopic retrograde cholangiopancreatography) is used in the diagnosis of disorders of the pancreas, bile duct, liver and gall bladder. The doctor passes an endoscope (a thin flexible telescope) through your mouth, to inspect your stomach and duodenum. The doctor then injects contrast dye into the drainage hole (papilla) from the bile ducts and pancreas, to take detailed x-rays (you should inform us if there is any possibility of pregnancy).
The doctor and the nurse will explain the procedure, and answer your questions. Please tell them if you have had any other endoscopy examinations, or any allergies or bad reactions to medications or contrast dye. You will be asked to sign a consent form giving permission for the procedure, to put on a hospital gown and remove eye glasses, contact lenses or dentures.
A Specialist Anaesthetist, will take a short history and examination prior to your procedure. They will provide sedation to make you very relaxed and comfortable for the procedure. The examination is performed on an x-ray table.
With you in a comfortable position on your left side, the doctor will pass the endoscope down your throat. A guard will be placed to protect your teeth. The endoscope will not interfere with your breathing and will not cause any pain. You may be asked to change positions during the examination which takes 15 - 60 minutes.
POST PROCEDURE
Your throat may feel slightly sore. Because of the sedation you should not attempt to take anything by mouth for at least 1 hour. If you are an out-patient you will remain in the clinic area for at least 1 hour. A companion must be able to drive you home as the sedation impairs your reflexes and judgement. For the remainder of the day you should not drive a car, operate machinery or make any important decisions. We suggest that you rest quietly. The hospital anaesthetic departments policy states you must be escorted home (you cannot travel unaccompanied in a taxi), and you must have someone stay with you overnight.
POTENTIAL COMPLICATIONS
Endoscopy can result in complications, such as reactions to medication, perforation of the intestine and bleeding. The risk of dental damage is minimised by using a mouthguard. Injection of contrast dye through the endoscope can cause allergic reactions, inflammation of the pancreas (pancreatitis) and of the bile duct (cholangitis). These complications are rare but may require urgent treatment, and even an operation. Be sure to inform us if you have any pain, fever or vomiting in the 24 hours after ERCP.
SPECIAL CONSIDERATIONS
X-rays are used as part of this procedure. It is therefore essential for women that there is no possibility of pregnancy. You should tell the hospital staff before the procedure if you have any doubt about this. It is desirable that you are not taking aspirin or arthritis tablets. If you are on these medications you should discuss the matter with your doctor. You should also inform your doctor, if you are taking blood thinning tablets, have heart valve disease or have a pacemaker implanted. To prepare for this procedure please make sure that you fast for 6 hours (no food or drink) prior to the procedure.