Endoscopic Retrograde Cholangiopancreatography (ERCP) in Kansas City, MO
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What is an ERCP?
Digestive Health Specialists perform endoscopic tests to evaluate a number of digestive health conditions in patients. An endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic procedure where a slender, elongated "scope" or tube is positioned into the oral cavity and advanced to the first portion of the small intestine, known as the duodenum. The device houses a camera and a light on the end of it, which enables the practitioner to evaluate the inner wall of the esophagus, stomach, small intestine, the opening to the bile duct, and the pancreatic duct. An ERCP test may be completed to diagnose the source of GI concerns, including:
- Abdominal pain
- Abnormal x-ray results
- Abnormal results from a liver test
Get in touch with our Kansas City, MO team today to set up an appointment with a GI specialist to find out more concerning an ERCP procedure.
What should I expect the day before my ERCP procedure?
Before your ERCP procedure, you will be given instructions from your doctor at Digestive Health Specialists outlining how to prepare and what to expect. Most patients will be allowed to eat as they normally would the day prior to the procedure. Patients will be advised not to eat or drink anything after midnight except for any medications. It is crucial to adhere to the instructions administered by your physician. Further instructions surrounding your medications may be given. In most instances, your medication regimen will be continued as usual. However, in certain instances, particularly in individuals taking blood thinners, (for example Coumadin®, Plavix®, warfarin, anti-inflammatories, and aspirin) and with diabetic patients, certain instructions will be given.
What can I expect during the ERCP procedure?
Our team will ask you to arrive at the endoscopy center in Kansas City, MO 1 – 1.5 hours prior to your procedure. This will provide you with time to complete patient forms and get ready for the evaluation. You will be asked to change into a medical gown. Our team will place an intravenous (IV) catheter in your arm in order for sedation to be administered. Special equipment will also be used to allow the doctor and our team to monitor your pulse, heart rate, blood pressure, breathing oxygen, and electrocardiogram levels throughout and after the test.
Once in the exam room, you will be asked to lie on your abdomen on the table. The sedation solution will then be given. A small amount will be administered at a time to help make certain that you do not have a reaction to the sedative and to provide only the dosage you need on an individual basis. In comparison with other variations of endoscopic tests, it is not uncommon for general anesthesia to be given for this procedure. After the appropriate level of sedation is established, the endoscope will be gently introduced into the mouth. The scope will be carefully advanced through the esophagus and into the stomach, and small intestine to the area where the pancreatic duct and bile duct open into the small bowel. A small portion of air is administered through the endoscope into the digestive tract to enhance visibility. With an ERCP, contrast dye is placed into the bile duct and the pancreatic duct. A radiographic (x-ray) imaging machine is utilized to take clear pictures of ducts to determine if there are any concerns or irregularities. Residual liquid in the upper GI structures can be eliminated through the scope. Based on the findings of the procedure, a few processes can be conducted at the time of the assessment, including tissue extraction for a biopsy, sphincterotomy (opening the bile duct or pancreatic duct), removal of gallstones from the bile ducts or stones from the pancreatic ducts, or placement of stents (plastic/metal tubes) into the bile duct or pancreatic duct. At the end of the procedure, as much of the air and residual fluid as possible will be withdrawn through the endoscope device. The procedure takes approximately 30 – 90 minutes to perform based on the results.
When the procedure is finished, you will be moved to the post-treatment room to be evaluated while the sedation starts to subside. The amount of sedation provided throughout the ERCP test and how you respond to it will impact how soon you wake up, although most individuals are alert enough for release within 45 – 60 minutes. You will not be able to drive any vehicles for the remainder of the day and will, therefore, need to have someone drive you home. You will also be instructed not to work, sign important papers, or perform strenuous activities for the rest of the day. In most cases, people can consume foods and beverages normally after being released from the endoscopy unit, though certain instructions surrounding medications, activity, and eating will be provided before release. Occasionally, patients might be required to stay in the hospital overnight for monitoring or evaluation.
When will I get my ERCP results?
Once the ERCP is complete, your GI provider and/or clinical staff will explain the results of the test to you. Many individuals will not recall what they are told following the ERCP evaluation because of sedation effects. Our Digestive Health Specialists team strongly suggests you to have someone accompany you with whom the ERCP outcomes can also be discussed, if possible. You will also go home with a typed report and will be advised of any biopsy or other test results usually within seven days.
What are the risks of an ERCP?
In general, ERCP is a very safe process. In most situations, any complications that develop are not life-threatening but, if a complication occurs, it might lead to the need for surgery and hospitalization. Before the test, a consent to treat form will be reviewed and discussed with the patient by the nursing staff. Treatment risks will again be discussed by the doctor before the procedure initiates, and any questions or concerns can be discussed.
Acute pancreatitis, or inflammation of the pancreas, is the most widespread complication. The condition may develop in 5 – 8% of patients, though, depending on the person, the risk can be up to 20%. Pancreatitis symptoms often include abdominal pain, nausea, vomiting, and possibly fever. The majority of cases are mild and require a hospital stay of four days or less. During the hospital stay, patients commonly only require nausea and pain control along with IV fluids. Seldom, however, pancreatitis can be more severe and even life-threatening.
Medication reactions from the sedation can occur. These reactions can include allergic reactions, difficulty breathing, effects on the heart and blood pressure, and irritation of the vein used to give the medication. Bleeding may result from a sphincterotomy or biopsy procedures. Major bleeding which could necessitate hospitalization or a blood transfusion, is highly unusual.
Perforation or piercing of the small bowel, stomach, or esophagus can happen. Such an event may be recognized at the time of the test, or it might not be noticed until later. The majority of the time, a perforation will result in surgery and hospitalization. This is still a very uncommon complication, even when a sphincterotomy is performed or biopsies are completed.
Among 5 – 10% of patients, the evaluation may not be able to be completed for varying reasons. It is extremely important that the patient get in touch with the doctor’s office immediately if any type of symptoms are experienced after the exam, such as bleeding, increasing abdominal pain, or fever.
Like any other test, endoscopic retrograde cholangiopancreatography is not perfect. There is a slight, recognized risk that abnormalities, including malignancies, go undetected with the exam. It is important to continue to visit your medical practitioners as recommended and bring to their attention any ongoing or new symptoms.
Should you need to have an ERCP in Kansas City, MO, our GI specialists can help you find the optimal options for your healthcare needs.
What are alternatives to an ERCP?
To a certain degree, any alternative options to the ERCP procedure will be dependent upon the underlying reason for needing the ERCP to begin with. For most patients, endoscopic retrograde cholangiopancreatography is the top approach to assess and address certain problems in the biliary and pancreatic systems. However, an imaging technique called a magnetic resonance cholangiopancreatography (MRCP), percutaneous transhepatic cholangiogram (PTC), or endoscopic ultrasound (EUS) or echo-endoscopy can likewise assess the bile and pancreatic ducts. On a further note, the magnetic resonance cholangiopancreatography is only a diagnostic exam. Treatment of concerns will involve an ERCP procedure or a surgical option. The EUS or PTC do have treatment alternatives.
Skilled care for endoscopic services
At Digestive Health Specialists, our group of experienced gastroenterologists frequently provides endoscopic retrograde cholangiopancreatography (ERCP) for Kansas City, MO patients. For help with understanding your options for gastrointestinal care, please get in touch with our facility today.
Wonderful Drs and staff.
Dr. Clement and staff made me feel very cared for and comfortable. All are friendly and compassionate. My overall experience was great.
Dr Able and staff were very kind, understanding with prior knowledge to what I needed which helped set the plan for moving forward. Thank you!!
My first appointment went very well. Dr. Able came highly recommended by my former gastroenterologist who retired.
Really seemed to care and wanted to figure out what is going on.