Re: Cyst? Need Advice - to Satish

[Guest guest]

Dear Satish,

I have copied and pasted an explanation of an ERCP below this message.

Many of the questions that you've asked have been answered earlier by

myself or other members.

You should follow the advise of the medical professionals that are treating

your mother for her multiple pancreatitis problems. I cannot advise you on

your questions regarding the hospital, being unfamilar with that part of the

country, but I do feel that the doctor's you've been working with are advising

you well, and they do recommend what they feel is best for your mother. They

are the professionals, and have much more experience in this matter than any

of us would.

The material below fully explains both the benefits and the risks involved in

this type of procedure. Many of our members have had ERCP's, some have

had them multiple times.

I hope this helps.

With love, hope and prayers,

Heidi

Heidi H. Griffeth

South Carolina Rep.

SE Regional Rep., PAI

Note: All comments or advice are based on personal experience or opinion

only, and should not be substituted for consultation with a medical

professional.

* * * * * * * * * * * * * *

ERCP

ERCP stands for endoscopic retrograde cholangiopancreatography. As hard

as this is to say, the actual exam is fairly simple. A dye is injected into the

bile

and pancreatic ducts using a flexible, video endoscope. Then x-rays are

taken to outline the bile ducts and pancreas.

The liver produces bile, which flows through the ducts, passes or fills the

gallbladder and then enters the intestine (duodenum) just beyond the

stomach. The pancreas, which is six to eight inches long, sits behind the

stomach. This organ secretes digestive enzymes that flow into the intestine

through the same opening as the bile. Both bile and enzymes are needed to

digest food.

Equipment

The flexible endoscope is a remarkable piece of equipment that can be

directed and moved around the many bends in the upper gastrointestinal

tract. The newer video endoscopes have a tiny, optically sensitive computer

chip at the end. Electronic signals are then transmitted up the scope to the

computer which then displays the image on a large video screen. An open

channel in the scope allows other instruments to be passed through it to

perform biopsies, inject solutions, or place stents.

Reasons for the Exam

Due to factors related to diet, environment and heredity, the bile ducts,

gallbladder and pancreas are the seat of numerous disorders. These can

develop into a variety of diseases and/or symptoms. ERCP helps in

diagnosing and often in treating the condition.

ERCP is used for:

* Gallstones, which are trapped in the main bile duct

* Blockage of the bile duct

* Yellow jaundice, which turns the skin yellow and the urine dark

* Undiagnosed upper-abdominal pain

* Cancer of the bile ducts or pancreas

* Pancreatitis (inflammation of the pancreas)

Preparation

The only preparation needed before an ERCP is to not eat or drink for eight

hours prior to the procedure. You may be asked to stop certain medications

such as aspirin before the procedure. Check with the physician.

The Procedure

An ERCP uses x-ray films and is performed in an x-ray room. The throat is

anesthetized with a spray or solution, and the patient is usually mildly

sedated. The endoscope is then gently inserted into the upper esophagus.

The patient breathes easily throughout the exam, with gagging rarely

occurring. A thin tube is inserted through the endoscope to the main bile duct

entering the duodenum. Dye is then injected into this bile duct and/or the

pancreatic duct and x-ray films are taken. The patient lies on his or her left

side and then turns onto the stomach to allow complete visualization of the

ducts. If a gallstone is found, steps may be taken to remove it. If the duct has

become narrowed, an incision can be made using electrocautery (electrical

heat) to relieve the blockage. Additionally, it is possible to widen narrowed

ducts and to place small tubing, called stents, in these areas to keep them

open. The exam takes from 20 to 40 minutes, after which the patient is taken

to the recovery area.

Results

After the exam, the physician explains the results. If the effects of the

sedatives are prolonged, the physician may suggest an appointment for a

later date when the patient can fully understand the results.

Benefits

An ERCP is performed primarily to identify and/or correct a problem in the bile

ducts or pancreas. This means the test enables a diagnosis to be made upon

which specific treatment can be given. If a gallstone is found during the exam,

it can often be removed, eliminating the need for major surgery. If a blockage

in the bile duct causes yellow jaundice or pain, it can be relieved.

Alternative Testing

Alternative tests to ERCP include certain types of x-rays (CAT scan, CT) and

sonography (ultrasound) to visualize the pancreas and bile ducts. In addition,

dye can be injected into the bile ducts by placing a needle through the skin

and into the liver. Small tubing can then be threaded into the bile ducts. Study

of the blood also can provide some indirect information about the ducts and

pancreas.

Side Effects and Risks

A temporary, mild sore throat sometimes occurs after the exam. Serious risks

with ERCP, however, are uncommon. One such risk is excessive bleeding,

especially when electrocautery is used to open a blocked duct. In rare

instances, a perforation or tear in the intestinal wall can occur. Inflammation

of

the pancreas also can develop. These complications may require

hospitalization and, rarely, surgery.

Due to the mild sedation, the patient should not drive or operate machinery for

six hours following the exam. For this reason, a driver should accompany the

patient to the exam.

****************************************

> She has been adviced to visit Asian Inst. of Gastrenterology, Hyderabad for

further treatment.

> Our local specialist has said that he has doubts that a cyst has been formed

and pancreas has large liquid / water accumulated in it.He has said that we

should not wait any further and visit this Hospital and may be we will be

required to go for operation.

>

> Whether any of the members have any idea regarding what we will

experince and what precautions we should take?

> What is ERCP? Whether these types of operations are risky? Do you know

about this Hospital and whether it is the BEST?

> Please advice.

> Thanks.

> -- Satish Suryawamshi,

> Sangli, India

> ***********************************************