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ERCP

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ERCP Treatment & Diagnostics in Koramangala, Bangalore

ERCP

Endoscopic retrograde cholangiopancreatography or ERCP is a specialized endoscopic test that can effectively identify diseases of the gallbladder, liver, biliary system, and pancreas. In this, doctors use a combination of an x-ray and an endoscope. An endoscope is long and thin with a light attached to it.

ERCP can provide crucial information that may not be possible to obtain by other diagnostic tests such as an MRI (magnetic resonance imaging), abdominal ultrasound, or a CT (computed tomography) scan.

Why Do Doctors Perform ERCP?

The liver, gallbladder, pancreas, and biliary ducts can suffer from a wide range of conditions, which cause a myriad of symptoms. These diseases must be examined and treated on time.

ERCP is an invaluable technique to detect and cure the following:

  • Due to obstruction in the bile duct, your skin gets a yellowish tinge (jaundice). It also causes pale-colored stools and dark-colored urine.
  • Persistent and unexplained abdominal pain.
  • To confirm the diagnosis of pancreatic cancer or cancer of the bile duct.
  • To find and clear blockage in the bile ducts caused due to cancer, stricture, or cancer.
  • To check for fluid leakage from the bile or pancreatic ducts.
  • Gallstones in the bile duct.

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What Are The Preparatory Steps for ERCP?

Before undergoing ERCP, you must inform your doctor if you are pregnant and if you are suffering from medication conditions like:

  • Lung conditions
  • Heart disorders. 
  • Diabetes and usage of insulin. Your doctor may want to adjust the dosage of insulin before the procedure.
  • You must also discuss with your doctor if you are allergic to any medication. 
  • Avoid eating or drinking anything eight hours before ERCP.
  • If you take any blood-thinning medication and herbal supplements, then consult with your doctor about the same.

Since doctors use anesthesia for ERCP, they recommend that someone accompanies you to the hospital, who can drive you home afterward.  

How Is ERCP Performed?

The name, endoscopic retrograde cholangiopancreatography, certainly looks complex, but the procedure is painless and not complicated. 

Generally, ERCP is an outpatient procedure, and a gastroenterologist performs it. It takes about 1-2 hours. Following is the stepwise description of a gastroenterologist conducts ERCP:

  • A nursing staff member helps you as you change from your clothes to a hospital gown.
  • Leave all your valuables like a watch, any jewelry, etc.
  • When you are in the operating room or the procedure room, the doctor asks you to lie down on the x-ray table.
  • Then he or she administers an anesthetic agent through an IV line put in your hand. General anesthesia is not needed.   
  • Using an anesthetic spray, the doctor numbs your throat. It prevents you from feeling gagged when the doctor passes the endoscope.t
  • Then, he or she inserts the endoscope into your mouth, guides it through your esophagus, stomach till it reaches the upper section of the duodenum (small intestine). 
  • Pumps air into the stomach and duodenum using the endoscope and duodenum. It gives clear visuals of your organs.
  • Then he or she slides another tube, known as a catheter, into the endoscope to access the bile and pancreatic ducts.
  • Using this catheter, the doctor injects a special dye.
  • As the dye travels through the ducts, your doctor takes the necessary video gastrointestinal X-rays (fluoroscopy). 

Depending on the required treatment, your doctor may insert varied instruments through the endoscope. Treatment can include:

  • Placing stents to open blocked or constricted ducts.
  • Breaking up and extracting the stones.
  • Removal of tumors.
  • Gathering tissue samples for biopsy.
  • Expanding a narrowed section of the duct 

What Happens After the Procedure?

Once the procedure completes, your doctor or a nurse shifts you to a recovery room. Till the effects of the sedative have worn off, the doctor monitors if you experience any discomfort. You may feel dizzy, nauseated, or bloated, but these are temporary effects. 

Your doctor allows you to leave after you feel comfortable. During the next appointment, your doctor discusses the ERCP reports with you. If there are disturbing findings in them, then your doctor talks about the future course of treatment.

Are There Any Post-ERCP Complications?

ERCP is a specialized procedure that has hardly any risks associated with it. Some minor complications or side-effects that may arise, like:

  • Sore throat, a mild and temporary side effect
  • Allergic reaction to the dye

There are a few risks, which occur rarely:

  • Excessive bleeding when the doctor uses electrocautery to open a blocked duct.
  • Bile duct or gallbladder Infection.
  • ERCP can also cause a tear in the lining of the upper section of the stomach, small intestine, or esophagus.
  • Bile accumulation outside the biliary system.
  • Bowel perforation in which a tear or hole may occur in the small bowel, stomach, ducts, or esophagus. 
  • Pancreatitis or inflammation of the pancreas.

Seek medical attention immediately if you experience any of the following symptoms in the next 72 hours:

  • Fever with chills
  • Severe abdominal pain
  • Nausea and vomiting
  • A continuous cough
  • Chest pain
  • Vomiting blood
  • Rectal bleeding

Conclusion

ERCP is used not only as a diagnostic tool but also as a therapeutic procedure. Also, considering its low invasiveness and the harmful ailments that ERCP can diagnose, it is recommended that you do not ignore your doctor’s instructions and undergo the procedure without any delay. 

References:

https://my.clevelandclinic.org/health/diagnostics/4951-ercp-endoscopic-retrograde-cholangiopancreatography

https://www.webmd.com/digestive-disorders/digestive-diseases-ercp 

https://www.medscape.com/viewarticle/496802

How long does it take to recover after the ERCP procedure?

You can take some rest for the next 24 hours till you feel completely fit. You can get back to your routine activities from the next day.

How soon can I start eating?

Since the pancreas is involved in the digestive process, eating too soon after ERCP can cause complications. Many health experts recommend having a light liquid diet 24 hours after this procedure.

Can the ERCP procedure fail?

Rarely, but the procedure can fail. However, ERCP can be repeated for the necessary treatment, and it is considered safe.

How soon can pancreatitis develop after ERCP?

You may notice the pain caused due to post-ERCP pancreatitis in the next six hours. It is unlikely to occur after 12 hours.

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