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ERCP (Endoscopic Retrograde Cholangio-Pancreatography)

5. ERCP blog
  • ERCP is a technique that enables your doctor to examine the pancreatic and bile ducts.
    They carry digestive juices from your liver and pancreas to the intestines.

Doctors use ERCP to treat problems of the bile and pancreatic ducts.
Doctors perform ERCP when your bile or pancreatic ducts have become narrowed or blocked due to one of the following conditions:
  • Stone in bile duct
  • Pancreatitis
  • Jaundice
  • Bile duct or pancreatic tumour
  • ERCP is done in a clinic or hospital. It is often done with sedation. You are not completely asleep during the procedure, but you are given injections called “sedatives” that make you relaxed and sleepy.

    Sometimes ERCP must be done under general anesthesia, with you completely asleep. If you need general anesthesia, 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 doctor who will perform your ERCP will talk with you about the risks and benefits of the procedure. Then you will sign a form saying you understand and agree to the procedure. Your doctor’s office will tell you what to do and avoid before surgery. The exact instructions depend on your doctor, but here are some common things to do.

    – Stop eating and drinking about 6 hours prior to the procedure

    –  Stop taking certain medicines such as blood thinners (Clopidogrel, Aspirin 150mg)

  • During an ERCP, a gastroenterologist (doctor who specializes in treating diseases of the gastrointestinal system), uses a special endoscope (a long, flexible tube with a light and camera at the end) to examine the inside of the digestive system . The doctor identifies the place where the bile duct comes into the intestine and then feeds a tiny catheter (a plastic tube) into the duct and squirts in a contrast agent while X-rays are taken. The contrast agent allows the doctors to see the bile ducts and the pancreatic duct on the X-rays.

    Once the source of the problem is identified, the doctor may then treat it by performing one of the following procedures.

    – This involves making a small incision (cut) in the opening of the pancreatic duct or the bile duct, which can help small gallstones , bile, and pancreatic juice to drain appropriately.

    – Stent placement : A stent is a drainage tube that is placed in the bile duct or the pancreatic duct to hold the duct open and allow it to drain.

    ERCP can remove gallstones from the bile duct, but not from the gallbladder itself.

    • After the procedure, you will be taken to the recovery room. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room or discharged home. If this procedure was done as an outpatient, plan to have someone drive you home.

      You will not be allowed to eat or drink anything until your gag reflex has returned. You may have a sore throat and pain with swallowing for a few days. This is normal.

      Many times, a rectal suppository of a certain medicine is given after the ERCP to decrease the risk of pancreatitis.

      You may go back to your usual diet and activities after the procedure, unless your healthcare provider tells you otherwise.

      Tell your healthcare provider if you have any of the following:

      – Fever or chills

      – Redness, swelling, or bleeding or other drainage from the IV site

      – Abdominal pain, nausea, or vomiting

      – Black, tarry, or bloody stools

      – Trouble swallowing

      – Throat or chest pain that worsens

       
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Dr. Harsh J Shah

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