ERCP as Day Case
ERCP Outpatient Information
This section of the wesbite details what an ERCP (Endoscopic Retrograde Cholangio Pancreatography) is, and provides information for patients preparing for the procedure. This information is also available in alternative format by clicking here.
What is an ERCP?
An ERCP (Endoscopic Retrograde Cholangio Pancreatography) is a test to examine the tubes that drain bile from your liver (the bile duct and gallbladder), and digestive juices from the pancreas (pancreatic duct). You will lie on an X-ray table and the doctor who is to perform the test will explain briefly what will happen. Your throat will be numbed with a special spray. You will be given an injection which will make you very sleepy (sedation).
Once you are sleepy, an endoscope (a long, thin flexible tube with a bright light at one end) will be passed through your mouth, down into your stomach and the upper part of the small intestine (the duodenum). A small plastic mouth guard will be used to protect the endoscope and you will be given a little oxygen to breathe during the test.
X-ray dye will be injected down the endoscope so that the pancreas and bile ducts may be seen on X-ray films. If everything is normal, the endoscope is then removed and the test is complete. The dye is passed out of your body harmlessly.
If the X-rays show a gallstone, the doctor may enlarge the opening of the bile duct (sphincterotomy) to allow the stones to pass into the intestine. If a narrowing is found, bile can be drained by leaving a short plastic tube (stent) in the bile duct. You will not be aware of the presence of the tube which may remain in place permanently.
Before the Procedure
Prior to the procedure you must have a blood test (unless this test is done the doctor cannot carry out the ERCP) You will need to attend the Gastroenterology department on the Thursday prior to your test on Monday, the receptionist will have a blood request form for you to take to the Haematology Department within the hospital, and you may go home as soon as the blood has been taken.
To allow a clear view, the stomach and duodenum must be empty. You will therefore be asked not to have anything to eat for at least 6 hours before the procedure and on the day of your procedure to only drink clear fluids, stopping 2 hours prior to your test.
You will be asked to undress and wear a hospital gown. It will also be necessary for you to remove any false teeth.
Medicines and Medical Conditions
It is important you bring a list of your current medication with you so that you can give it to the nurse on arrival.
Warfarin
If you are taking Warfarin tablets, please inform the Gastroenterology Unit as soon as possible, as our doctors may decide that it is necessary for you to stop taking your tablets for a limited time before the gastroscopy.
Diabetes
If you suffer from diabetes, please inform the Gastroenterology Unit as soon as possible, as it may be necessary to change the time of your appointment or be admitted to hospital a day before your procedure for treatment. If your diabetes is managed by your GP please contact the surgery for advice. If under the care of Elsie Bertram Diabetes Centre , please contact your Diabetes specialist nurse on 01603 288513.
Pregnancy
If you are pregnant or breast-feeding please contact the Gastroenterology Unit .
Consent
When you come to the department, the procedure will be explained and a doctor will ask you to sign a consent form. This is to ensure you understand the test and its implications/risks. If you have any worries or questions at this stage don’t be afraid to ask. The staff will want you to be as relaxed as possible for the test and will not mind answering your queries.
After the Procedure
You will be left to rest as you may feel sleepy if you have had sedation. The staff will explain the results of the tests and what treatment has been given. Once you have returned home, you may begin to eat and drink normally and resume your normal medication, unless instructed otherwise by the Doctor.
If you have had sedation you must have someone to escort you home and stay with you for the 24 hours after your test. Following sedation you must not do any of the following for 24 hours:
- Drive a motor vehicle
- Drink Alcohol
- Operate Machinery
- Sign Legal Documents
Side effects of this procedure are usually minimal, sometimes patients may experience discomfort and / or a sore throat for a few days. This can be relieved by normal analgesia. You will be given an advice sheet on after care and signs to watch for when you have had your procedure.
Risks and Complications
This procedure is very safe with only minimal complications. The two commonest are pancreatitis and bleeding. The incidence of these complication are small, but if you have any problems after ERCP which you may feel to be related to the test please inform your doctor or the hospital staff at once.
Acute pancreatitis
This is inflammation of the pancreas and can cause abdominal pain often going into the back and associated with vomiting.
Bleeding
Bleeding can occur if a cut has been made to remove stones. Bleeding can cause vomiting of blood which may be black, or the passing dark black stools.
Additional information can be found at these websites:
The American Society of Gastrointestinal Endoscopy
CORE (formally Digestive Disorders Foundation)