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ERCP How the Test is Performed:
This
test is usually done in the hospital. Your throat is sprayed with a local
anesthetic. A sedative and pain killer are given through a vein. A special
flexible tube (endoscope) is inserted through your mouth into the duodenum (the
portion of the small intestine that is closest to the stomach). A catheter is
advanced through the endoscope and inserted into the pancreatic or biliary
ducts. A contrast agent is injected into these ducts and X-rays are taken to
evaluate their caliber, length and course. Narrowing, stones, and tumors can be
identified. Special instruments can be placed through the scope and into the
ducts to open the entry of the ducts into the bowel, stretch out narrow
segments, remove or crush stones, take tissue samples, and drain obstructed
areas.
How to Prepare:
You will need to fast 12 hours
before the test and sign a consent form. Remove all jewelry so that it will not
interfere with the X-ray .
Infants
and children:
The physical and psychological preparation you can provide
for this or any test or procedure depends on your child's age, interests,
previous experience, and level of trust. For specific information regarding how
you can prepare your child, see the following topics as they correspond to your
child's age:
How it Feels:
There may be some gagging as the tube is passed down the esophagus. As the scope is positioned, there will be some stretching of the stomach and duodenum . Occasionally, stretching of the ducts can be felt. Air, used to inflate the stomach and bowel, can cause some distention. After the procedure, you will have a sore throat for 3 to 4 days. There may be some reaction to the dye.
Risks:
There is a possibility of side effects from the dye and the drug used to relax the duodenum . These may include nausea , hives , blurred vision , a dry mouth, a feeling of burning or flushing , and retention of urine. The risks of the procedure are determined by the therapy delivered. If the opening into the small bowel is enlarged by electrocautery (called a sphincterotomy) there is a risk of bleeding , perforation of the bowel, and pancreatitis . The risk of any complication is less than 10%. Severe complications (severe pancreatitis, severe bleeding) occur in less than 1%.
Why this Test is Performed:
The procedure identifies any abnormality of the pancreas or bile ducts that can cause abdominal pain , jaundice , fever , or malabsorption . These include:
Normal Values:
The X-ray will show normal structures for the age of the patient.
Abnormal Results:
Abnormal results may indicate stones or narrowing of the ducts, presence of tumors, cancer , cirrhosis (hardening of an organ and inflammation), and cysts (abnormal cavity filled with fluid or semisolid substances).
Additional conditions under which the test may be performed:
Cost:
The
estimated cost is $725 to $800 for the physician and about $750 to $800 for the
hospital. The total cost is about $1,500 to $1,600.
Special Considerations:
Not
applicable.
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