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2630 Grant Line Road
New Albany, IN 47150
Phone:
812-945-0145
Fax: 812-949-5435
825 University Woods
Drive, Ste. 2
New Albany, IN 47150
Phone:
812-945-0145
Fax: 812-949-5443
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The doctors of Gastroenterology of Southern Indiana must often perform
routine procedures for the evaluation and treatment of many digestive tract
problems. The information below is meant as a reference only and should
not be used as diagnostic treatment.
ERCP
(Endoscopic Retrograde
Cholangiopancreatography)
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General information
ERCP is a sophisticated study of the bile ducts and the pancreas.
This study is the gold standard for evaluation of biliary and pancreatic
abnormalities. ERCP is performed to remove gallstones in the
common bile duct, evaluate the pancreas and treat gallstone
pancreatitis.
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Reasons for exam
ERCP can be helpful in diagnosing or treating a number of conditions
such as:
- Gallstones which are trapped in the main (common) bile duct
- Blockage of the bile duct
- Yellow jaundice (the skin becomes yellow)
- Pancreatitis (inflammation of the pancreas)
- Cancer of the bile ducts of pancreas
- Abdominal pain of several causes
Preparation for the exam
You should discuss your medication with your physician prior
to the procedure. Usually, medications are not taken the morning
of the procedure. However, some medications should be taken if the
procedure is to be done later in the afternoon. Adjustments in
your insulin dose should also be discussed with your physician.
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Equipment
The endoscope is a thin flexible lighted tube which is passed through
the mouth into the upper small intestines. It contains an
optically sensitive computer chip in the tip which transmits the signal
onto a video screen. Dials permit the physician to steer the
instrument in every direction. Other instruments can be passed
through the endoscope to remove stones, relieve obstructions, and
perform other tasks. The procedure is performed with the patient
under an x-ray camera so that the bile ducts and pancreas can be
continuously observed. Only the most state-of-the-art equipment is
used.
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Benefits
ERCP is the last invasive and most specific way of evaluating the bile
ducts and pancreatic ducts. It can be performed safely and with
minimal discomfort. In addition to providing a diagnosis, in many
cases it allows the physician to perform specific treatment.
Frequently a sphincterotomy (papillotomy) is performed. This
procedure uses a thin wire with electrical cautery to enlarge the
opening of the bile duct. Stones can be removed or a drainage tube
(stent) can be placed to relieve an obstruction.
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Risks & side effects
No test is 100% accurate and infrequently ERCP can miss abnormalities
which are present. In addition, sometimes for anatomical reasons
it is not possible to inject the contrast material into the ducts.
You may have a feeling of bloating which is temporary.
Complications are very uncommon. Oversedation occurs infrequently and almost always can be reversed.
A localized irritation of the vein can occur at the IV site resulting in
a tender lump which may last for several weeks. Application of hot
moist towels may relieve the discomfort. Pancreatitis
(inflammation of the pancreas) occurs in about 2-5% of cases (5-10% if
sphincterotomy is required). In most cases the pancreatitis is
mild but severe cases can occur. Other potential complications
include bleeding (rarely requiring transfusion or surgery), perforation (a tear in one of the organs),
infection of the bile or pancreas, worsening of underlying heart or lung
disease, and adverse reaction to one of the sedatives. Any of these complications could involve hospitalization, emergency
surgery, or in an exceptionally rare case, death. |
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