FAQ for ERCP for the newbies on the group

[Guest guest]

FAQ for ERCP (Endoscopic Retrograde Cholangiopancreatography)

What is ERCP?

ERCP is a specialized technique used to study the pancreas, gallbladder and the

ducts of the liver. An endoscope, which is a flexible thin tube, is passed

through the mouth, esophagus and stomach into the duodenum. After the common

opening to ducts from the liver and pancreas is visually identified, a catheter

(a narrow plastic tube) is passed through the endoscope into the ducts. Contrast

material is then injected gently into the ducts (pancreatic or biliary) and

x-rays are taken.

Why is ERCP done?

ERCP is a valuable tool that is used to diagnose many diseases of the pancreas,

bile ducts, liver and gallbladder. Structural abnormalities suspected due to

symptoms, physical examination, laboratory tests, or x-rays can be shown in

detail and biopsies of abnormal tissue can be obtained if necessary. ERCP can

make the important distinction between whether jaundice (yellow discoloration of

the eyes and skin) is caused by diseases that are treated medically, such as

hepatitis, or structural diseases, such as gallstones, tumors or strictures

(obstructing scar tissue), which are treated surgically or endoscopically. In

patients who are not jaundiced but have pain or laboratory abnormalities

suggesting biliary or pancreatic disease, ERCP may also provide important

diagnostic information. ERCP can be used to determine whether or not surgery is

necessary and is helpful in providing the anatomic detail the surgeon needs to

plan an operation when surgery is needed. The information provided by an ERCP is

far more detailed than that provided by standard x-rays or scans. Several

conditions of the biliary or pancreatic ducts can be treated by therapeutic ERCP

techniques that can open the end of the bile duct, extract stones and place

stents (plastic or metal drainage tubes) across obstructed ducts to improve

their drainage.

What preparation is required?

For the best-and safest-examination, the stomach must be completely empty. You

should have nothing to eat or drink, including water, for at least six hours

(and preferably overnight) before the procedure. Your doctor will be more

specific about the time to begin fasting, depending on the time of day that your

test is scheduled. It is best to inform your doctor of your current medications

as well as any allergies several days prior to the examination. You should alert

your doctor if you require antibiotics prior to undergoing dental procedures

since you may need antibiotics prior to upper endoscopy as well. You will

probably be sedated and will need to arrange to have someone accompany you home

from the examination because sedatives may affect your judgment and reflexes for

the rest of the day.

What can be expected during ERCP?

Your physician will discuss why ERCP is being performed, potential complications

from ERCP and alternative diagnostic and therapeutic tests that are available. A

local anesthetic may be applied to your throat and an intravenous sedative may

be given to make you more comfortable during the test. Some patients also

receive antibiotics before the procedure. The test begins with you lying on your

left side on an x-ray table. The endoscope is passed through the mouth,

esophagus and stomach into the duodenum. The instrument does not interfere with

breathing. Air is introduced through the instrument and may cause temporary

bloating during and after the procedure. The injection of contrast material into

the ducts rarely causes discomfort.

What are the possible complications of ERCP?

ERCP is generally safe when performed by physicians who have had special

training and experience in this technique. Localized irritation of the vein

where medication was given may cause a tender bump that can last for weeks. The

application of heat packs or hot moist towels to the area may ease discomfort.

Major complications requiring hospitalization can occur but are uncommon during

diagnostic ERCP. They include serious pancreatitis, infections, bowel

perforation and bleeding with each occurring in less than 1% of patients.

Another potential risk of ERCP is an adverse reaction to the sedative used. Your

physician will tell you what is your likelihood of complications before

undergoing the test.

What happens after ERCP?

After the test, you will be monitored in the endoscopy area until most of the

effects of the medication have worn off. Your throat may be a little sore for a

while, and you may feel bloated immediately following the procedure because of

the air introduced into your stomach during the test. You will be able the

resume your diet after you leave the procedure area unless you are instructed

otherwise.

It is important for you to recognize the signs of any possible complications. If

you begin to run a fever after the test, have trouble swallowing, or have

increased throat, chest, or abdominal pain, let your doctor know about it

promptly.

Source: Some portions of the ERCP FAQ are from the

American Gastroenterological Association.

The message can be found at the following URL:

http://www.eboards4all.com/539945/messages/229.html

Entered From:216.228.187.179