Phil's update Fri. Sept.23

[Guest guest]

Phil is scheduled for an ERCP endoscopy to open his bile duct on Tuesday

Sept. 27.

I have included information on the procedure below my message.

The " fun " never ends huh? This should resolve the jaundice and hopefully be

the last of the big stuff for a while.

There has still been no real reaction to the new chemo. Not even the acne

like stuff.

He does tire faster but other than that he feels pretty good.

As always your prayers are needed and appreciated

Narice and Phil

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Endoscopic retrograde cholangiopancreatography

Definition

Endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic

procedure used to identify stones, tumors, or narrowing in the bile ducts.

How the test is performed

This test is usually done in the hospital. The throat is sprayed with a

local anesthetic. A sedative and pain killer are given through a vein. A

special

flexible tube (endoscope) is inserted through the mouth into the duodenum

(the portion of the small intestine that is closest to the stomach).

A catheter is advanced through the endoscope and inserted into the

pancreatic or biliary ducts. A contrast agent is injected into these ducts and

x-rays

are taken to evaluate their caliber, length and course. Narrowing, stones,

and tumors can be identified.

Special instruments can be placed through the scope and into the ducts to

open the entry of the ducts into the bowel, stretch out narrow segments, remove

or crush stones, take tissue samples, and drain obstructed areas.

Mild to severe inflammation of the pancreas is the most common complication

and may require hospital care, even surgery. Bleeding can occur when the

papilla has to be opened to remove stones or put in stents. This bleeding

usually

stops on its own, but occasionally, transfusion may be required or the

bleeding may be directly controlled with endoscopic therapy.

A puncture or perforation of the bowel wall or bile duct is a rare problem

that can occur with therapeutic ERCP. Infection can also result, especially if

the bile duct is blocked and bile cannot drain. Treatment for infection

requires antibiotics and restoring drainage. Finally, reactions may occur to

any

of the medications used during ERCP, but fortunately these are usually minor