ERCP (cont.)
What kind of preparation is required?
For the best possible examination, the stomach must be empty. The
patient should not eat anything after midnight on the evening preceding
the exam. In case the procedure is performed early in the morning, no
liquid should be taken. In case the examination is performed at noon time,
a cup of tea, juice, milk, or coffee can be taken 4 hours earlier. Heart
and blood pressure medications should always be taken with a small amount
of water in the early morning. Since the procedure will require
intravenous sedation, the patient needs to have a companion drive him/her
home after the procedure.
What can be expected during and after the procedure?
The patient will be given medication through a vein to cause relaxation
and sleepiness. The patient will be given some local anesthetic to
decrease the gag reflex. Some physicians do not use local anesthetic and
prefer to give the patients more intravenous medication for sedation. This
also applies to those patients who have a history of allergy to Xylocaine,
cannot tolerate the bitter taste of the local anesthetic, or the numbness
sensation in the throat. While the patient is lying on the left side on
the x-ray table, the intravenous medication is given and then the
instrument inserted gently through the mouth into the duodenum. The
instrument advances through the food pipe and not the air pipe. It does
not interfere with the breathing and gagging is usually prevented or
decreased by the medication.
When the patient is in semi-conscious state, he/she can still follow
instructions to change the position on the x-rays table. Once the
instrument has been advanced into the stomach, there is minimal discomfort
except for the foreign body sensation in the throat. The procedure can
last any where from fifteen minutes to one hour, depending on the skill of
the physician and the anatomy or abnormalities in that area.
After the procedure, the patients should be observed in the recovery
area until most of the effects from the medication have worn off. This
usually takes one to two hours. The patient may feel bloated or slightly
nauseated from the medication or the procedure. Very rarely a patient
experiences vomiting and may belch or pass some gas through the rectum.
Upon discharge, the patient should be driven home by his/her companion and
is advised to stay home for the rest of the day. The patient can resume
usual activity the next day. Even though the physician may explain to the
patient or companion regarding the findings after the procedure, it is
still necessary to call the physician the next day to ensure that the
patient understands the results of the examination.
Next: What are the reasons for the examination? »
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