myendoscopy.co.uk

Dr Ajay M Verma, Dr Solange Serna

©2019 myEndoscopy.co.uk

Kettering General Hospital NHS Foundatio
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How do I have an ERCP?

To make sure the endoscopist has unhindered access to the opening of the bile ducts within the duodenum, your stomach must first be prepared.

This section outlines the steps of having a gastroscopy:

  • Pre-procedure preparation

  • Arrival to the unit

  • During the procedure

  • After the procedure

Pre-procedure preparation

To ensure that the endoscopist performing the procedure as unhindered access to the opening of the bile ducts, your stomach must be empty.

You must adhere to the following instructions to assist the endoscopist with the procedure.

As Soon As Possible

If you take an anticoagulant such as warfarin, you must contact the anticoagulation clinic as soon as you have a date for your procedure.

If you are a diabetic, you should contact the Endoscopy Unit to inform them as this may affect the time of your appointment.

6 Hours Before

No food can be taken for 6 hours prior to your admission time.

Up to 2 Hours Before

You can take small amounts of clear fluids up to two hours before your admission time. These include water, juice, squash, black teas and coffee. NO fizzy drinks.

2 Hours Before

NOTHING AT ALL can be taken by mouth 2 hours before your admission time.

TESTING WILL NOT BE CARRIED OUT IF THE ABOVE STEPS HAVE NOT BEEN TAKEN.

During the procedure

Arrival to the unit

When you arrive at the Endoscopy Unit you will first be booked in by the receptionist. After this you will be reviewed by a member of the specialist nursing team who will ask you a few questions about your medical condition as well as your arrangements for getting home after the procedure.

 
The nurse will also record your heart rate, blood pressure and oxygen levels. If you are a diabetic they will also measure your blood glucose level. This information is used to confirm that you are fit enough to undergo the procedure.

Finally, the nurse will ask you to remove some of your clothing and change into a hospital gown. You may also like to bring your dressing gown and slippers. Conscious sedation is given through a plastic tube called a ‘venflon’, which will be placed in the arm or hand. 


You may now have to wait some time before your procedure starts. Before you go into the endoscopy room, the endoscopist will come and discuss with you the aspects of the procedure, you will then be asked to sign the 
consent form which will explain why you are having the procedure as well as the associated risks and benefits. You can withdraw your consent for the procedure at point. Should you have any further questions or need to raise any concerns; the endoscopist will gladly discuss them with you. 

During the procedure

Once you are ready for your procedure, you will be taken into the examination room (see 1st image) where the team of nurses and the endoscopist will introduce themselves. The team will do checks to confirm your details (see 2nd image), your medications and confirm you understand the procedure and have signed the consent form.  You will be asked to remove any dentures and glasses. The endoscopist and the nursing staff will be wearing protective equipment - lead aprons (see 3rd image).  

 

Before the test you will be given a throat spray (banana flavoured) which will act as a local anaesthetic to numb your throat (see 4th image). After the throat spray you will have a tooth guard placed in your mouth through which the endoscope is passed. This will not stop you from being able to breathe.

 

The nurse looking after you will assist you in lying on the trolley on your left side, with your left arm behind your back (see 5th image).  They will put a probe on your finger on so that your oxygen level is monitored during the procedure.


The procedure starts with the administration of a light sedative and a painkiller (see 6th image - this is NOT a general anaesthetic; it will be given via an injection through the venflon in the back of your hand or your arm. Once the sedative is given you may feel a little sleepy but not deeply anaesthetised. The sedative might mean that you have reduced memory of the procedure taking place after a few days.

 

The endoscopist will start the procedure by manoeuvring the duodenoscope to the correct position to access the bile ducts (see 7th image). The endoscopist will then access (cannulate) the bile ducts and inject contrast (see 8th image - a fluid that is visible on X-ray screening and shows the outline of the bile ducts). The endoscopist then will perform the appropriate treatment required.


The nurses looking after you will be with you at all times giving you reassurance and support throughout the procedure which will usually last about 20-45 minutes. You may experience some discomfort during the procedure (usually when the scope is inserted) but it will not be painful.

After the procedure

When can I eat?

You may sleep for about an hour after the procedure, after which you will be offered a drink and some light refreshments.

Will I have any pain?

Some patients experience a sore throat after the procedure, but this should wear off within 24-48 hours.

When can I go home?

Before you leave the Unit, a member of the team will explain what happened during the procedure and whether you need any further appointments. 


Sedation can make you drowsy for up to 24 hours after the procedure. Therefore you must be collected and accompanied home.  If you live alone it may also be a good idea to arrange to stay with a friend or relative.

For 24 hours after sedation you must not: 

 

  • drive

  • drink alcohol

  • operate heavy machinery

  • sign any legally binding documents

After you go home

You will be able to return to your normal activities, both at home and at work, when you feel comfortable.

If you have a question or concern after the test, please phone the Endoscopy Unit.

You must consult your nearest A&E department if you: develop severe chest pain, a fever or pass large amounts of blood &/or black tarry stools after the procedure.