Endoscopic Retrograde Cholangiopancreatography (ERCP) in Thibodaux, LA

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Digestive Health Center carries out endoscopic procedures in Thibodaux, LA to evaluate various types of gastrointestinal (GI) conditions. An endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic procedure where a flexible, thin "scope" or tube is inserted into your oral cavity and gently advanced to the first portion of the small intestine or the duodenum. The scope houses a light and a camera on the end of it which enables your provider to evaluate the internal tissues of the esophagus, stomach, small intestine, the entrance to the bile duct, and the pancreatic duct. An ERCP may be recommended to diagnose the cause of GI concerns such as:

  • Pain in the abdominal area
  • Abnormal X-ray results
  • Abnormal results from a liver test
  • Pancreatitis

Reach out to your nearest Thibodaux, LA location to request a consultation with a GI specialist to learn more about this endoscopic procedure.

What are the benefits of an ERCP?

An ERCP may be recommended if blood tests show abnormal liver results, if you have inflammation of the pancreas, or if you experience symptoms such as pain in the abdomen or yellowing of the eyes and skin. Some benefits of an ERCP include:

  • Diagnostic and therapeutic: This approach may serve dual purposes, helping doctors diagnose diseases or conditions and perform treatment within the same procedure. As such, this can reduce the need for multiple interventions.
  • Short recovery times: Individuals commonly have quicker recovery periods with an ERCP as opposed to conventional surgical approaches, enabling an expedited return to daily or routine activities.
  • Enhanced precision: An ERCP enables the direct treatment and visualization of the biliary and pancreatic ducts. This is imperative for accurate diagnosis and treatment of a condition.
  • Efficiency: The ability to detect and treat a health issue during one procedure often minimizes the total treatment time for patients.

You will receive instructions from our team at Digestive Health Center outlining the steps you need to take to prepare for your ERCP. In most situations, you will be allowed to eat normally the day before the test. We will instruct you not to eat or drink anything after midnight except for any medications. It is imperative to adhere to these instructions administered by your doctor. Additional information surrounding your medications will likely be given. In most circumstances, your medications will be followed as usual. However, in certain cases, particularly in those taking anti-coagulants, (such as warfarin, Plavix®, Coumadin®, aspirin, and anti-inflammatories) and with diabetics, special instructions will be given.

You will need to arrive at the endoscopy center in Thibodaux, LA 1 – 1.5 hours before your ERCP procedure. This is to allow time to fill out paperwork and get ready for the exam. You will be asked to put on a medical gown. Our clinical team will place an intravenous (IV) line in your arm to prepare for sedation to be administered. Special equipment will also be used to allow the physician and staff to monitor your pulse, heart rate, blood pressure, breathing oxygen, and electrocardiogram levels during and after the ERCP.

Upon entering the exam room, you will lie on the table. The sedation will then be administered. Small amounts are administered at a time to help ensure that you do not have a reaction to the sedative solution and to ensure we only administer the amount you require. In comparison with other endoscopic procedures, it is not atypical for general anesthesia to be administered for this procedure. After the appropriate sedation level is reached, the endoscope device will be gently inserted into the mouth. The scope will be gently advanced through the esophagus and into the stomach, and small intestine to the area where the pancreatic and bile ducts empty into the small intestine. A small portion of air is injected via the scope into the gastrointestinal tract to increase visibility. In an ERCP, contrast dye is injected into the bile duct and the pancreatic duct. An X-ray machine is utilized to capture pictures of the bile duct and pancreatic duct to identify whether there are any irregularities or concerns. Residual liquid in the upper GI structures can be eliminated by way of the scope device. Based on the findings of the procedure, several things might be conducted during the course of the procedure, including tissue extraction for a biopsy, removal of gallstones from the bile ducts or stones from the pancreatic ducts, stent placement (plastic/metal tubes) into the bile duct or pancreatic duct, and sphincterotomy (opening the bile duct or pancreatic duct). When the ERCP is complete, we will remove as much of the air and residual fluid as possible through the endoscope. In general, the exam takes about 30 – 90 minutes to perform based on the findings.

After the procedure is finished, you will be taken to the recovery room to be assessed while the sedation starts to fade away. The extent of sedation utilized throughout the ERCP procedure and how you respond to it will affect how quickly you awaken, although most individuals are alert enough for discharge within 45 – 60 minutes. You cannot drive for the rest of the day; therefore, you will need to have a relative or friend drive you home. You will also be directed not to sign important documents, work, or engage in strenuous activity for the rest of the day. The majority of patients can consume foods and beverages as normal after discharge from the endoscopy unit, although key instructions concerning eating, activity, and medications will be provided before discharge. Occasionally, patients may be required to stay in the hospital overnight for evaluation. If this is the case for you, we will follow up accordingly.

When your ERCP is complete, your GI team will go over the results of the evaluation with you. Most often, patients do not remember what is discussed after the ERCP evaluation because of sedation effects. Our Digestive Health Center staff highly recommends you have someone with you with whom the ERCP outcomes can also be discussed. You will also be provided with a typed report and will be contacted with any test or biopsy results generally within seven days.

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Endoscopic retrograde cholangiopancreatography, in general, is a very safe process. If any complications arise, the majority of them are not life-threatening. However, should a complication arise, it could lead to the need for hospitalization or surgery. Before beginning the ERCP exam, a consent form will be explained to and reviewed with you so you understand the associated risks, as unlikely as they may be. Treatment risks will again be rediscussed by the doctor before the ERCP test starts, and any questions or concerns can be addressed at either time.

A condition referred to as acute pancreatitis, or inflammation of the pancreas, is the most common complication. It may arise in 5 – 8% of individuals, although, depending on the individual, the risk can be up to 20%. Signs and symptoms of pancreatitis may include nausea, vomiting, pain in the abdominal area, and possibly fever. Most cases are not severe and require no more than four days in the hospital. While in the hospital, patients usually only require IV fluids along with nausea and pain control. Rarely, however, pancreatitis can be more concerning and may be life-threatening.

Negative reactions from the sedation can occur. These can include but are not limited to irritation of the vein used to give the medication, effects on the heart and blood pressure, allergic reactions, and breathing difficulties. Bleeding can occur with biopsy procedures or a sphincterotomy. Significant bleeding, which may necessitate hospitalization or a blood transfusion, is highly unusual.

The piercing or perforation of the small bowel, stomach, or esophagus can occur. Such an occurrence may not be recognized at the time of the ERCP exam, or it might not be apparent until a later time. In most situations, a puncture of this type will result in a hospital stay and surgery. However, this is still a very uncommon complication, even in the event where a sphincterotomy is performed or biopsies are completed.

Finally, in 5 – 10% of cases, the ERCP evaluation may not be able to be carried out for varying reasons. It is very important that you get in touch with your provider right away in the event symptoms occur after the exam, such as increasing abdominal pain, bleeding, or fever.

Like any other exam, ERCP is not flawless. There is a small, accepted risk that disease, including malignancies, may not be detected at the time of the exam. It is essential to continue to follow up with your medical practitioners as instructed and inform them of any persistent or new symptoms.

Should you need to have an ERCP in Thibodaux, LA, our GI doctors can help you determine the appropriate solution for your health.

To a certain degree, the alternative options to the ERCP procedure will be dependent upon the purpose for needing the ERCP to begin with. For most individuals, the ERCP process is the best approach to identifying and treating certain problems in the biliary and pancreatic structures. However, an X-ray image referred to as a magnetic resonance cholangiopancreatography (MRCP), percutaneous transhepatic cholangiogram (PTC), or endoscopic ultrasound (EUS) or echo-endoscopy can also assess the bile and pancreatic ducts. It is important to note that the MRCP is only a diagnostic tool; addressing any concerns will need to be accomplished through an ERCP or a surgical approach. In addition, EUS or PTC do have treatment options.

What are some questions to ask my physician about ERCP?

If you discover that you require an ERCP, you'll likely have several questions or concerns and may be unsure of where to start. Questions to consider asking your gastrointestinal doctor may include:

  • If a complication should arise, are there any symptoms or signs you might experience?
  • What is the general success rate of this procedure?
  • What does your doctor anticipate finding during this procedure?
What should I avoiding doing after undergoing an ERCP?

You cannot operate a vehicle for 24 hours after an ERCP as the sedative medication might still be in your body. As such, you will need to have a friend or relative take you home after your procedure. We may instruct you to hold off on eating for a certain period depending on the type of treatment performed during your ERCP. Our team may also advise taking the remainder of the day and potentially the next day off work. Your Digestive Health Center team can explain what to anticipate throughout the course of the ERCP process.

What procedures can be conducted during an ERCP?

Procedures commonly performed during the course of the ERCP process are:

  • Stent placement (pancreatic and biliary ducts)
  • Tissue sampling
  • Stone removal (within the bile duct)
  • Sphincterotomy (of the biliary sphincter)
How might I prepare for an ERCP?

Our Thibodaux, LA digestive health team will give you directions on how to prepare for an ERCP procedure. However, some of the instructions you may need to follow are:

  • Do not eat or drink for eight hours before your ERCP procedure. (Water may be okay to drink. Check with your provider to confirm.)
  • Do not smoke for eight hours before your appointment.
  • Give your GI provider a list of all prescription and nonprescription medications you are currently taking in addition to any allergies you may have.

At Digestive Health Center, our team of experienced gastroenterology specialists commonly performs endoscopic retrograde cholangiopancreatography (ERCP) for Thibodaux, LA patients. For more information on the gastrointestinal services available to you, please contact your nearest location to request a consultation.

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