About Your ERCP
What is an ERCP?
ERCP (Endoscopic Retrograde Cholangiopancreatograph)
is an examination of the pancreas, bile ducts,
liver, and gallbladder for diseases. ERCP allows
your physician to perform necessary treatments,
such as enlarging a bile duct opening, removing
gallstones lodged in the bile duct, inserting
a stent (drain) in the duct or taking a biopsy
specimen (tiny bit of tissue).
During ERCP, a flexible tube (duodenoscope) is
passed through the mouth, esophagus (food tube)
and stomach into the duodenum (first part of the
small intestine) (see Figure 1). A small
plastic tube is passed through the duodenoscope
into the ampulla (opening where the bile and pancreatic
ducts empty in the duodenum) (see Figure 2).
X-ray dye is injected through the tube into the
ducts. X-rays are then taken to study the ducts.
Any necessary treatments can be performed at this
time.
Plan
to Do in Advance
1. Medications, Vitamins and Supplements
To properly prepare for your procedure, you may
need to make certain changes to your daily medication
routine.
- If you take insulin, consult with your physician
about making any necessary changes in you daily
regimen.
- If you take medications that contain aspirin
or other anti-inflammatory drugs (such as Motrin,
Advil, Indocin, or Feldene), we recommend that
you stop taking them seven days before your
procedure. They may increase your risk of bleeding
after removal of a polyp or a biopsy during
your ERCP by interfering with the normal clotting
of your blood.
- IMPORTANT: IF YOU ARE CURRENTLY TAKING COUMADIN
OR HEPARIN, YOU MUST CHECK WITH YOUR PRESCRIBING
PHYSICIAN BEFORE CHANGING OR INTERRUPTING YOUR
DAILY ROUTINE.
- Certain medications should be continued
prior to your ERCP. If you take cardiac (heart)
or anti-hypertensive (high blood pressure) pills,
take them as you normally do with small sips
of water.
2. In addition to changes to your medication,
you'll also need to:
- Bring a list of all your medications (prescription
medications, over-the-counter medications and
eye drops) with you on the day of your procedure.
You may bring the medication bottles themselves.
- Be prepared to list and describe your ALLERGIES
and REACTIONS to any medications.
3. Because you will receive a relaxing medication
during your procedure, you must arrange to have
a responsible adult pick you up and/or accompany
you home if you taking public transportation.
University of Pennsylvania Health System policy
requires that you make these arrangements, or
your procedure will not be performed. You
may not operate an automobile or other mechanical
equipment until the day following your procedure.
On
the Day Before Your Procedure
To ensure the most accurate results possible,
it is important that you do not eat or drink anything
after midnight on the day before your procedure.
The exception is medication taken with small sips
of water.
On
the Day of Your Procedure
- On the day of your ERCP, please come directly
to the requseted location at your scheduled
arrival time and check in with the receptionist.
Plan to spend several hours at the unit to allow
time for your preparation, your procedure, and
your recovery.
- Before the procedure, a nurse will greet
you and assist you with changing into a hospital
gown. An IV will be placed in your arm. You
will receive relaxing medications through the
IV during the procedure. The duodenoscope will
be passed through the mouth, esophagus, and
stomach into the duodenum (first part of the
small intestine). The physician will view the
ducts by X-ray.
After
Your Procedure
- After the ERCP, you will be taken to the
recovery area where you will be monitored until
most of the effects of the relaxing medication
have worn off. If certain therapeutic procedures
are performed, you physician may recommend observation
overnight in the hospital.
- You may have some cramping or bloating as
a result of the air placed into your stomach
during the procedure.
- The Endoscopist will discuss the results
of your procedure with you prior to your discharge.
You will receive discharge instructions on the
day of the test.
- Your endoscopy report and biopsy results
will be sent to your referring physician.
If you would like to speak to a nurse regarding
your procedure or preparation, or if you need
to reschedule your procedure, please call the
appropriate number:
Hospital of the University of Pennsylvania
Procedure questions: 215-662-2122
To reschedule: 215-349-8222
Penn Presbyterian Medical Center
All questions: 215-662-8900
Penn Medicine at Radnor
All questions: 610-920-1500
Please be aware that these instructions apply
to patients scheduled for procedures at the Hospital
of the University of Pennsylvania, Penn Presbyterian
Medical Center and Penn Medicine at Radnor. However,
your doctor may give you different instructions
or procedures. If you have any questions about
your procedure, please contact your physician
at the Digestive & Liver Center.
Digestive System Illustration
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