Endoscopy RetrogradeCholangiopancreatography [ERCP]

• Biliary System

• ERCP is an endoscopic procedure used to identify the presence of stones, tumors, or narrowing in the biliary & pancreatic ducts
• ERCP can also help find cancer or non-cancerous lesions
• After the endoscope with x-ray is properly placed, a catheter is advanced which will inject a contrast agent through the ducts
• ERCP can help diagnose problems following gallbladder surgery

• Gallstones can be removed from the bile duct & sometimes from the pancreas
• ERCP to put in a small plastic tube called a "stent" if your bile duct is blocked
• ERCP can help treat problems following gallbladder surgery

• A procedure location will be suggested based on your insurance & geographic area
• Please refer to the locations page on our website

• Do not plan to drive after your procedure
• You must have someone 18 years old or above to drive you home
• No Uber | Lyft | Cab

The pre-assessment testing team will discuss the following:

• Clearance if necessary
• Medical History
• Medications
• Pre-anesthesia questionnaire
• Surgical history

• Hospital, anesthesia & pathology fees are independent from GastroDoxs
• The other fees not related to GastroDoxs are to be discussed directly with the other providers, hospital or surgery center
• If you have not heard from the financial representative 24 hours before your procedure, call them at that time

• You may need a clearance if you have high risk conditions requiring clearance
• You may need a follow-up with your Doctor or Provider before they can issue a clearance
• Our team will send your Doctor or Provider a clearance request from our office
• Once our team has your clearance on file, we will call you to schedule your procedure
• You may need a clearance if you are on blood thinners or these medications
  • Apixaban [Eliquis]
  • Clopidogrel [Plavix]
  • Dabigatran [Pradaxa]
  • Edoxaban [Savaysa]
  • Prasugrel [Effient]
  • Rivaroxaban [Xarelto]
  • Ticagrelor [Brilinta]
  • Warfarin [Coumadin & Jantoven]

• Hold > Anti-Diarrheal Medication - Imodium, Kaopectate, Pepto-Bismol
• Hold > Iron Tablets
• Hold > Multivitamins

• Hold > Oral Diabetes Medication
• Insulin > Take ½ the dose

• Blood Pressure Medication > as instructed by the pre-assessment team

• Continue to take your medications unless specified below
• Blood thinners will require a clearance on file before scheduling
• The pre-assessment team (PAT) will review your medications & may make other recommendations also

• Stop - All food after 12am [midnight]
• Stop - All liquids after 12am [midnight]

• Please ensure you arrive 1-1.5 hours before your procedure
• You will check in at registration when you arrive

• The clinical team will go through the clinical assessment as well as risks & benefits of the procedure
• The anesthesia team will explain all aspects before the procedure
• Consent forms the procedure will need to be signed

• An intravenous line will be inserted into your arm to administer medication
• You will be given intravenous sedation medication during the procedure

• If any diagnostic tissue samples or biopsies are required it can be obtained through the endoscope with x-ray during the procedure
• Biopsies may be taken

• If intervention is required, it will be done during the procedure
• Stones, strictures may be removed & photographs may be taken

• Biopsies are tissue samples that are reviewed by a Pathologist under the microscope
• The Pathologist will determine the nature of the tissue samples
• The Pathologist will send the reports to our office

• Our providers will review the report in detail
• The findings will be reviewed with you in detail upon follow-up

• You will be under observation for 30 minutes to monitor for any symptoms
• You will be awake within 30 min but may still be groggy for 12-24hrs
• Do not plan to drive the remainder of the day after your procedure

• Do not plan to drive after your procedure
• You must have someone 18 years old or above to drive you home
• No Uber | Lyft | Cab

Normal post procedure symptoms:

• Bloating
• Gas
• Slight abdominal pain
• Some diarrhea
• Weakness

Abnormal post procedure symptoms:

• Bleeding
• Excessive vomiting
• Fever >100
• Severe abdominal pain
• Any other severe or unusual symptoms
• Please call 911 & go to the nearest emergency room

• Your results will be discussed in detail
• Treatment recommendations will be given