Endoscopic Retrograde Cholangiopancreatography (ERCP) in Arizona

You will need to enter at the endoscopy center in Phoenix, AZ 1 – 1.5 hours ahead of your ERCP evaluation. This will provide you with time to fill out patient forms and get ready for your ERCP. You will then need to put on a medical gown. An intravenous (IV) catheter will be placed in your arm so that sedation can be provided. We will also connect you to equipment that will allow the physician and staff to monitor your heart rate, blood pressure, pulse, electrocardiogram, breathing, and oxygen levels throughout and after the procedure.

Upon entering the exam room, you will lie on your stomach on the stretcher. Your IV sedation will then be started. A small dose will be provided at a time to ensure that you do not have any reaction to the sedative solution and to administer only the dosage you need on an individual basis. In comparison with other types of endoscopic tests, it is not unusual for general anesthesia to be performed for an ERCP exam. Once an adequate sedation level is achieved, the endoscope device will be gently inserted into the mouth. The flexible device will be carefully forwarded through the esophagus and into the stomach, and small intestine to the position where the pancreatic duct and bile duct open into the small bowel. A small portion of air is injected through the endoscope into the GI system to help the specialist see. During an ERCP exam, radiographic contrast dye is introduced into the bile and pancreatic ducts. An x-ray machine is utilized to take pictures of these structures to detect whether there are any abnormalities. Residual liquid in the upper digestive structures can be removed through the scope device. Depending on any discoveries, a few things can be carried out during the evaluation, such as tissue extraction for a biopsy, opening the bile duct or pancreatic duct (sphincterotomy), removal of stones from the pancreatic ducts or gallstones from the bile ducts, or the placement of stents (plastic/metal tubes) into the bile or pancreatic ducts. When the procedure is complete, as much of the remaining fluid and air as possible will be suctioned out through the endoscope device. In general, the ERCP evaluation takes about 30 – 90 minutes to complete based on the results.

When the evaluation is over, you will be taken to the recovery room to be assessed while the sedative effects begin to subside. The amount of sedation used during the procedure and your body's response to it will determine how quickly you wake up, though most people are awake enough for dismissal within 45 – 60 minutes. You cannot operate any vehicles for the remainder of the day and should, therefore, arrange for a ride home. You will also be instructed not to perform strenuous activities, sign important documents, or work for the rest of the day. Most patients can eat and drink normally following discharge from the endoscopy unit, although certain instructions regarding activity, medications, and eating will be provided before release. Sometimes, ERCP patients will need an overnight hospital stay for for assessment or monitoring.

After the ERCP procedure, the physician and/or nursing team will explain the conclusions of the test with you. Most individuals have little recollection of the information provided following the ERCP procedure as a result of sedative effects. Our Arizona Digestive Health team recommends you to bring someone with you to whom the ERCP findings can also be explained, when possible. You will also be given a typed report and will be contacted with any biopsy or other test results usually within one week.