ERCP - Endoscopy of the Biliary Tract and Pancreas

The examination is performed with the help of a flexible device (endoscope) that is inserted through the mouth into the duodenum and reaches up to the opening of the bile duct and pancreas. THROUGH THE ENDOSCOPE CANAL, A PLASTIC TUBULE IS INSERTED INTO THE APERTURE OF THE PAPILLA AND THROUGH IT A CONTRAST AGENT BASED ON IODINE IS INJECTED, WHICH ALLOWS (UNDER X-RAY MIRRORING) TO EXPOSE THE BILE DUCTS AND PANCREAS. With ERCP it is also possible to perform therapeutic actions such as removing stones from the biliary tract and pancreas, dilating the arteries (blockage) and taking tissue samples (in case of suspected cancer or precancerous condition) and inserting a stent to drain the bile and pancreas and keep them open, for example in situations where there is obstruction.

• ERCP is a test that takes an average of about 40 minutes.
• The examination is carried out under obfuscation (sedation) or anesthesia, which is administered through a vein before the examination.
• After receiving the blur, a “tooth holder” will be inserted into your mouth, the purpose of which is to keep your mouth open throughout the examination.
• The test is performed lying on the left side or on the stomach. During the examination, monitoring devices will be connected to your body to check your heart rate, blood pressure, and respiratory activity.
• During the examination, the doctor inserts the device through the mouth and places it in the area of the papilla, which is the opening of the biliary tract and pancreas into the small intestine. Through the papilla it is possible to enter the biliary tract or pancreas for treatment, for example cleaning stones, taking a biopsy from a lump or opening a blockage.
• In some cases, the patient will be given prophylactic antibiotics at the time of the operation to prevent infection.

• Regular medications for hypertension and heart disease should be continued on the morning of the examination. Detailed instructions should be given on how to deliver blood-thinning drugs such as Fluix, Warfarin, etc.
• For diabetics — do not inject insulin or take any other medicine on the morning of the test.
• If you are using CPAP/BPAP respiratory support devices due to nocturnal apnea or obstructive pulmonary disease, you should bring the device for gastroscopy examination.
• If you have asthma, it is recommended that you take a dose of the inhaler two hours before the start of the test.
• If you have a pacemaker or defibrillator, a checkup at a pacemaker clinic is required about two weeks before the gastroscopy is performed. Gastroscopy examination should be reached with a summary of a visit to a pacemaker clinic.

• After the examination, you will be transferred to a recovery room, where you will be able to rest under supervision.
• The duration of recovery usually ranges from half an hour to an hour and at the end you can drink and even start eating.
• There may be a temporary feeling of abdominal swelling and pain due to the introduction of air during the examination. This feeling will be relieved and disappear after removing gases.
• It is important to remember that there is a small percentage of complications after the operation including inflammation and bleeding. In the case of severe abdominal pain, you may be referred to the ER for further clarification and exclusion of significant complications.
• When you feel well and well, you will be released to your home by the nurse.
• The results of the examination will be given by the doctor after the examination, preferably in the presence of a relative or other person close to you. If biopsies were taken, their results will be sent by mail a few weeks after the examination
• Consult with the examining doctor and the family doctor about returning to the use of regular medications, especially blood thinners.