Endoscopic Retrograde Cholangiopancreatography (ERCP) in St. Louis, MO

You will need to arrive at the endoscopy center in St. Louis, MO an hour to an hour and a half ahead of your ERCP procedure. This will give you time to complete patient forms and get ready for your ERCP. You will then need to change into a medical gown. An intravenous (IV) catheter will be started in your arm for sedation to be given. We will also connect you to equipment that will allow your specialist and our team to monitor your pulse, heart rate, blood pressure, breathing oxygen, and electrocardiogram levels during and after the procedure.

After you enter the treatment room, you will then lie on your stomach on the stretcher. Then, the IV sedation will be administered. Small amounts are administered at a time to ensure that you do not have an adverse reaction to the sedation medication and to administer only the dosage you need individually. In comparison with other endoscopic exams, it is not uncommon for general anesthesia to be utilized for an ERCP exam. Once an adequate sedation level is established, the endoscope will be gently placed into the mouth. The flexible scope will be gently advanced through the esophagus and down into the stomach, and small intestine to the area where the bile duct and pancreatic duct empty into the small bowel. A small pocket of air is administered through the scope into the GI tract to enhance visibility. In this procedure, radiographic contrast dye is introduced into the biliary and pancreatic ducts. An x-ray imaging machine is used to capture clear images of these structures to detect whether there are any concerns or abnormalities. Any fluid remaining in the upper digestive tract can be suctioned out via the endoscope. Based upon what the procedure reveals, a few treatments can be performed at the time of the ERCP, including tissue biopsies, sphincterotomy (opening the bile duct or pancreatic duct), removal of gallstones from the bile ducts or stones from the pancreatic ducts, or placement of stents (plastic/metal tubes) into the bile duct or pancreatic duct. Once the ERCP is complete, as much of the air and remaining fluid as possible will be extracted by way of the endoscope. On average, the ERCP exam takes around 30 – 90 minutes to perform based on the results.

After the exam is over, you will be moved to the recovery area to be monitored while the sedation medication begins to wear off. The extent of sedation provided during the exam and your body's response to the medication will determine how fast you wake up; however, most people are awake enough for discharge within 45 – 60 minutes. You cannot operate any vehicles for the remainder of the day and will, therefore, need to plan to have a friend or relative take you home. You will also be advised not to work, sign important papers, or perform strenuous activities for the rest of the day. The majority of individuals can eat and drink normally after being dismissed from the endoscopy unit, however, pertinent instructions concerning medications, activity, and eating will be reviewed before release. There may be times when patients may be required to stay in the hospital overnight for for assessment or monitoring.

When the ERCP is complete, the specialist and/or nursing team will explain the procedure's findings to you. Generally, individuals do not recall what they are told in the wake of the evaluation due to the effects of the sedation. Our Specialists in Gastroenterology team recommends that you bring someone with you to whom the ERCP outcomes can also be explained, when possible. You will also go home with a typed report and will be notified of any test or biopsy results typically within seven days.