Procedures
ERCP
- During an endoscopic retrograde cholangiopancreatography, or ERCP, the gastroenterologist uses an endoscope, a long, thin, flexible tube with a light and camera at the end, through the esophagus, the stomach, and the first part of the small intestine, called the duodenum. Once the endoscope reaches the papilla, which is the opening of the common bile duct, the physician injects dye through these ducts, enabling x-rays to be taken.
- Bile, a liquid that helps digest fat, is produced by the liver and carried to the gallbladder, where it is stored, through a series of tubes called ducts. The main duct from the pancreas joins the common bile duct and allows pancreatic juices to help with further digestion in the duodenum. After eating, both bile and pancreatic juices flow through the papilla and into the duodenum, where they mix with food and play a major role in digestion.
- A physician may recommend an ERCP if the patient is experiencing abdominal pain or develops jaundice (yellowing of the eyes). This procedure is helpful in identifying gallstones, tumors or scar tissue obstructing the bile duct. After using x-ray imaging to discover the nature of the obstruction, the endoscopist is usually able to clear the ducts. This is done by cutting open the papilla and then either pushing or pulling the stone out, or by inserting a device, such as an inflatable balloon, to help stretch scar tissue.
- The patient remains comfortable during the procedure with the help of IV sedation. The drugs will enable the patient to remain semi-conscious throughout the procedure, but usually prevent the patient from remembering the experience.
Patient preparation for the procedure
The procedure normally takes about 40 minutes. Afterwards, the patient waits in the recovery room while the anesthetic wears off. Soreness in the back of the throat is not uncommon once the anesthesia dissipates. Due to the lingering effects from the sedation, the patient cannot drive or work for the remainder of the day, and therefore must have a ride home.
Dr. Kunal Das
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