Endoscopic Retrograde Cholangiopancreatography (ERCP) in Northwest Arkansas

Please plan to arrive at the endoscopy unit 1 – 1.5 hours before your ERCP exam. This will allow adequate time to fill out paperwork and prepare for the evaluation. You will then need to change into a medical gown. Our clinical team will place an intravenous (IV) line in your arm to allow sedation to be given. We will also connect you to equipment that will enable the physician and staff to monitor your breathing, oxygen, pulse, blood pressure, heart rate, and electrocardiogram levels throughout the course of and after the test.

Upon entering the exam room, you will be asked to lie on your abdomen on the table. Your IV sedation will then be started. To ensure your safety and limit the risk of an adverse reaction, small amounts of sedation will be administered at a time. When compared to other endoscopic tests, it is not atypical for general anesthesia to be used for an ERCP exam. When the necessary sedation level is reached, the endoscope device will be carefully inserted into the mouth. The flexible device will be gently moved through the esophagus, stomach, and small intestine to where the pancreatic and bile ducts open into the small bowel. A small portion of air is injected via the endoscope into the gastrointestinal (GI) tract to enhance visibility. During an ERCP procedure, contrast dye is injected into the biliary and pancreatic ducts. An x-ray machine is utilized to capture images of these structures to determine if there are any concerns or abnormalities. Residual liquid in the upper digestive tract can be suctioned out by way of the endoscope. Depending on the findings of the exam, several processes can be done during the course of the ERCP, such as biopsies, 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. Once the procedure is complete, as much of the air and remaining fluid as possible will be withdrawn via the endoscope. On average, the assessment takes around 30 – 90 minutes to perform depending on the results.

When the assessment is over, you will be moved to the post-treatment room to be monitored while the sedation medication begins to wear off. The dosage of sedation utilized throughout the ERCP procedure and your response to the medication will determine how quickly you wake up, though most people are awake enough to be released within 45 – 60 minutes. You cannot operate any vehicles for the remainder of the day and should, therefore, arrange for a ride home. You will also be instructed not to perform strenuous activities, sign important documents, or work for the remainder of the day. The majority of times, individuals can drink and eat normally after being dismissed from the endoscopy unit, but specific instructions involving medications, activity, and eating will be given prior to discharge. There may be times when patients are admitted to stay in the hospital overnight for evaluation.

Once the ERCP procedure is finished, the specialist and/or clinical team will review the results of the exam with you. Most individuals do not remember what they are told in the wake of the process because they are still recovering from the sedation effects. Our GI Alliance of Arkansas team highly recommends you bring someone with you with whom the outcomes can also be discussed, when possible. You will also go home with a typed report and will be informed of any biopsy or other test results generally within a week.