Endoscopic Retrograde Cholangiopancreatography (ERCP) in Ocean Springs, MS

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Digestive Health Center offers endoscopic evaluations to diagnose various gastrointestinal (GI) conditions and diseases. An endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic procedure where a slender, flexible tube or “scope” is placed into the mouth and advanced to the first portion of the small intestine or the duodenum. The scope contains a light and a camera on the end, which permits the provider to examine the lining of the esophagus, stomach, small intestine, the opening to the bile duct, and the pancreatic duct. An ERCP test may be completed to detect the source of gastrointestinal concerns, such as:

  • Abdominal pain
  • Abnormal x-ray results
  • Abnormal results from a liver test
  • Pancreatitis

Contact a local Ocean Springs, MS location today to request an appointment with a GI provider near you to hear more about this procedure.

An ERCP test may be necessary if blood tests show abnormal liver results, if you have pancreatic inflammation, or if you experience symptoms such as abdominal pain or yellowing of the eyes and skin. Some benefits of this test are:

  • Diagnostic and therapeutic: This approach serves dual purposes, helping physicians detect conditions and provide treatment during the same process. As such, this can minimize the need to undergo multiple procedures.
  • Reduced recovery times: Patients commonly experience expedited recovery periods with an ERCP compared to traditional approaches involving surgery, allowing for an expedited return to daily activities.
  • Enhanced precision: An ERCP allows for the precise treatment and visualization of the pancreatic and biliary ducts. This is essential for correct diagnosis and treatment of a condition.
  • Efficiency: The opportunity to identify and treat a health issue during a single procedure commonly decreases the overall treatment process.

Before your ERCP procedure, you will receive specific instructions from your Digestive Health Center provider regarding the steps to take to prepare. In most instances, you will be able to eat as you usually do the day before the exam. Patients will be advised not to drink or eat after midnight except for medications. It is crucial to adhere to the information and instructions given by your provider. Further information concerning your medications will be provided. In most circumstances, your medication regimen will be followed as usual. However, specific instructions will be given in some instances, particularly for those on blood thinners (i.e., anti-inflammatories, aspirin, Coumadin®, Plavix®, warfarin) and diabetic patients.

Our team will ask you to enter the Ocean Springs, MS endoscopy center 1 – 1.5 hours prior to your assessment. This will give you ample time to fill out patient forms and prepare for the exam. You will be asked to put on a medical gown. An intravenous (IV) catheter will be placed in your arm so that sedation can be provided. We will also be connected to equipment allowing the provider and our team to monitor your blood pressure, heart rate, pulse, oxygen, breathing, and electrocardiogram levels throughout and after the test.

Once in the exam room, you will lie down on your abdomen on the bed. The IV sedation will be started. A small amount will be provided at a time to help ensure that you do not have a reaction to the sedative solution and to administer only the personalized dosage you require. Unlike other types of endoscopic exams, it is not unusual for general anesthesia to be used for an ERCP exam. After the appropriate level of sedation is reached, the endoscope will be placed into the mouth. The flexible device will be carefully advanced through the esophagus, stomach, and small intestine to the position where the bile duct and pancreatic duct empty into the small bowel. A small portion of air is administered via the scope into the gastrointestinal (GI) system to enhance visibility. During the ERCP procedure, an iodine-based contrast dye is injected into the biliary duct and pancreatic duct. A radiographic (x-ray) imaging machine is utilized to capture clear pictures of the biliary and pancreatic ducts to identify whether there are any abnormalities or concerns. Residual liquid in the upper digestive tract can be withdrawn via the scope. Depending on any findings, several things can be carried out during the evaluation, including tissue extraction for a biopsy, stent placement (metal/plastic tubes) into the bile or pancreatic ducts, sphincterotomy (opening the bile or pancreatic duct), and the removal of gallstones from the bile ducts or stones from the pancreatic ducts. When the ERCP is complete, as much of the remaining fluid and air as possible will be withdrawn through the endoscope device. The procedure generally takes approximately 30 – 90 minutes, depending on the findings.

When the exam has concluded, you will be taken to the recovery area to be assessed while the sedative effects begin to subside. The extent of sedation utilized during the exam and how your body responds to the medication will dictate how soon you awaken; however, most individuals are awake enough to be released within 45 – 60 minutes. You cannot drive for the remainder of the day and should, therefore, arrange for a ride home in advance. You will also be advised not to perform strenuous activities, work, or sign important documents for the rest of the day. Most individuals can resume eating and drinking as usual after discharge from the endoscopy unit, although important instructions regarding activity, eating, and medications will be administered before discharge. Occasionally, ERCP patients might need an overnight hospital stay for monitoring or evaluation.

After the ERCP procedure, the provider and/or clinical staff will review the evaluation findings with you. Most patients do not recall what they are told following the ERCP assessment because of the effects of the sedation. Our Digestive Health Center staff highly recommends you have someone with you with whom the results can also be discussed, if possible. You will also be discharged with a typed synopsis and typically advised of any biopsy or other test results within a week.

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ERCP, in general, is known to be a very safe procedure. Most complications that arise are not life-threatening; however, if a complication does occur, it could require hospitalization and surgery. Before the ERCP evaluation, a consent form for treatment will be reviewed and explained to you by the clinical team. The provider will once again explain the risks before the ERCP procedure begins, and any questions or concerns can be addressed at that time.

Acute pancreatitis is the most predominant complication. This condition may occur in 5 – 8% of cases, though, depending on individual factors, the risk can be as high as 20%. Symptoms of pancreatitis may include abdominal pain, nausea, vomiting, and possibly fever. Most cases are mild and require a hospital stay of four days or less. While hospitalized, patients commonly only need pain and nausea control and IV fluids. A small percentage of the time, however, pancreatitis can be more concerning and may even be life-threatening.

Adverse reactions associated with sedation can arise. These reactions can include difficulty breathing, effects on blood pressure and the heart, irritation of the vessel used to administer the sedative, and allergic reactions. Bleeding can result from a sphincterotomy or biopsies. Significant bleeding, which might require a blood transfusion or hospitalization, is very uncommon.

Perforation of the small intestine, stomach, or esophagus can take place. This may be identified at the time of the exam, or it may not be recognized until a later time. Most of the time, a puncture of this type will lead to surgery and hospitalization. However, this is a rare complication, even when biopsies are completed or a sphincterotomy is conducted.

For 5 – 10% of cases, the endoscopic retrograde cholangiopancreatography exam may not be able to be performed for various reasons. It is essential that the patient contact the provider’s office right away if any symptoms occur following the exam, such as bleeding, increasing abdominal pain, or fever.

Like any other test, an endoscopic retrograde cholangiopancreatography is not perfect. There exists a small, acknowledged risk that abnormalities, including malignancies, can be missed at the time of the exam. It is imperative to continue to seek care from your medical providers as instructed and let them know of any new or persistent symptoms.

Should you need to have an ERCP in Ocean Springs, MS, our GI specialists can help you select the optimal options for your health.

To a certain extent, any alternatives to ERCP will depend on the underlying reason for needing to undergo endoscopic retrograde cholangiopancreatography in the first place. For most patients, the ERCP procedure is the best way to identify and address irregularities in the pancreatic and biliary systems. However, an x-ray image called a magnetic resonance cholangiopancreatography (MRCP), percutaneous transhepatic cholangiogram (PTC), or endoscopic ultrasound (EUS), also known as an echo-endoscopy, can additionally assess the bile and pancreatic ducts. The MRCP is only a diagnostic exam. Addressing any issues will involve an ERCP or a surgical procedure. However, a PTC or EUS does have treatment options.

What are some questions to ask my physician about the ERCP procedure?

If you are told that you require an ERCP, you'll probably have several questions or concerns and may need help figuring out where to start. Some common questions to ask your GI provider might involve:

  • What does your physician expect to find during this procedure?

  • What is the general success rate of an ERCP?

  • If a complication occurs, are there any signs or symptoms you might notice?

What should you avoid doing after an ERCP?

You cannot drive for 24 hours following an ERCP procedure since the anesthesia may still be in your system; therefore, we ask you to have a relative or friend drive you home after your procedure. Our team might instruct you to avoid eating for a certain timeframe, depending on what treatment is performed during the ERCP. We also suggest taking the remainder of the day and possibly the following day off work to recover. Our Digestive Health Center team can discuss what to anticipate before, during, and after your procedure.

What types of procedures might be performed during an ERCP?

A few of the common treatments performed during the ERCP process involve:

  • Placement of stents
  • Tissue sampling
  • Removal of stones (gallstones in the bile duct)
  • Biliary sphincterotomy
How should I prepare for an ERCP?

Our Ocean Springs, MS digestive health team can administer instructions on prepping for an ERCP procedure. However, a few directions you might be asked to follow include:

  • Do not eat or drink for eight hours before your procedure. (Water may be okay to consume. Ask your provider for confirmation.)
  • Avoid smoking for eight hours before your ERCP appointment.
  • Provide your GI provider with a list of nonprescription and prescription medications you are currently taking, along with any known allergies you may have.

At Digestive Health Center, our group of experienced gastroenterologists routinely provides endoscopic retrograde cholangiopancreatography (ERCP) for Ocean Springs, MS patients. For more information on the gastrointestinal services available, please contact a local provider in your community today.

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