Endoscopic Retrograde Cholangiopancreatography (ERCP) in Little Rock, AR

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GastroArkansas performs endoscopic evaluations to assess various types of gastrointestinal (GI) diseases in patients. An endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic procedure where a long, thin, flexible tube or “scope” is placed into the mouth and gently moved to the first portion of the small intestine, known as the duodenum. The scope is fitted with a camera and a light that lets the physician evaluate the inner wall of the esophagus, stomach, small intestine, the opening to the bile duct, and the pancreatic duct. An ERCP examination may be performed to detect the cause of gastrointestinal concerns, including:

  • Abnormal liver test
  • Abnormal x-ray results
  • Abdominal pain
  • Pancreatitis

Call our Little Rock, AR practice today to reserve an appointment with a GI physician to hear further details concerning this procedure.

Prior to your scheduled ERCP procedure, you will be provided with instructions from our team at GastroArkansas detailing the steps to take to prepare. In most situations, you can eat your normal diet the day leading up to the exam. Patients will be instructed not to ingest anything by mouth after midnight except for any medications. It is crucial to follow the information and instructions provided by your provider. Additional information regarding your medications will likely be given. In general, your medication schedule will be followed as usual. In certain cases, especially in people taking blood thinners, (such as Coumadin®, Plavix®, warfarin, anti-inflammatories, and aspirin) and with diabetics, certain instructions will be given.

You will be asked to arrive at the endoscopy center in Little Rock, AR 1 – 1.5 hours prior to your exam. This will provide you with time to fill out paperwork and prepare for the assessment. You will be asked to put on a medical gown. Our team will place an intravenous (IV) catheter in your arm so sedation can be given. Special equipment will also be used that will allow the doctor and our team to monitor your heart rate, blood pressure, pulse, electrocardiogram, breathing, and oxygen levels throughout the course of, and after, the test.

When you enter the treatment room, you will then position yourself on your abdomen on the table. The sedation solution will then be administered. A small amount will be administered to make certain that you do not have any reaction to the sedative solution and to limit it to only the amount you need on an individual basis. In comparison with other types of endoscopic tests, it is not unusual for general anesthesia to be utilized for an ERCP procedure. After a sufficient sedation level is established, the endoscope will be gently placed into the mouth. The scope will be gently advanced through the esophagus, stomach, and small intestine to the location where the pancreatic and bile ducts empty into the small bowel. A small amount of air is injected via the scope into the digestive system to help the specialist see. In this procedure, an iodine-based contrast dye is placed into the biliary and pancreatic ducts. An x-ray machine is utilized to take pictures of the bile duct and pancreatic duct to see if there are any concerns or abnormalities. Any fluid remaining in the upper digestive tract can be suctioned out through the endoscope. Based on what the procedure reveals, several things might be carried out during the course of the ERCP, such as tissue biopsies, removal of gallstones from the bile ducts or stones from the pancreatic ducts, stent placement (plastic/metal tubes) into the bile duct or pancreatic duct, and sphincterotomy (opening the bile duct or pancreatic duct). At the end of the ERCP, as much of the residual fluid and air as possible will be removed through the endoscope. In general, the procedure takes around 30 – 90 minutes to perform.

When the assessment has concluded, you will be escorted to the post-treatment room to be evaluated while the sedative effects begin to wane. The extent of sedation used throughout, and how you respond to it, will determine how fast you wake up, though most people are alert enough for discharge within 45 – 60 minutes. You cannot operate any vehicles for the rest of the day and should, therefore, plan to have a friend or relative take you home. You will also be directed not to work, perform strenuous activities, or sign important papers for the rest of the day. The majority of the time, people can eat and drink as usual after being released from the endoscopy unit, however, important instructions involving eating, medications, and activity will be given prior to dismissal. There may be times when ERCP patients may be admitted to stay in the hospital overnight for evaluation.

When the ERCP is complete, the specialist and/or nursing staff will discuss the findings of the test with you. Many individuals do not remember the information provided in the wake of the procedure as a result of the effects of the sedation. Our GastroArkansas staff advises you to bring someone with you with whom the ERCP findings can also be discussed, when possible. You will also be provided with a typed synopsis and will be contacted with any test or biopsy results often within a week.

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Endoscopic retrograde cholangiopancreatography, in general, is regarded as a very safe assessment. In most situations, any complications are not life-threatening, however, in the event a complication occurs, it may require the need for surgery and hospitalization. Prior to the start of the exam, a consent to treat form will be reviewed and explained to the patient by the clinical team. The risks will once again be rediscussed by the doctor before the procedure begins, and any questions or concerns can be addressed.

Acute pancreatitis, or inflammation of the pancreas, is the most widespread complication. The condition may occur in 5 – 8% of patients, although, depending on the person, the risk can run up to 20%. Signs and symptoms of pancreatitis may include nausea, vomiting, abdominal pain, and in some instances, fever. The majority of cases are mild and require four or fewer days in the hospital. During the hospital stay, patients commonly only require IV fluids along with pain and nausea control. A small percentage of the time, however, pancreatitis can be more serious and even life-threatening.

Negative reactions related to sedation can arise. Reactions can include allergic reactions, difficulty breathing, effects on the heart and blood pressure, and irritation of the vein used to give the medication. Bleeding may result from a sphincterotomy or biopsy procedures. Significant bleeding, like that which might necessitate a blood transfusion or hospitalization, is highly unusual.

Perforation of the esophagus, stomach, or small bowel can happen. Such an event may be recognized at some point during the ERCP test, or it may not be recognized until later in the day. In most cases, a perforation will result in surgery and hospitalization. This is a rare complication, even in the event where biopsies are taken or a sphincterotomy is performed.

Among 5 – 10% of individuals, the exam might not be able to be completed for various reasons. It is highly essential that the patient gets in touch with the physician’s office right away if any symptoms develop following the exam, such as increased abdominal pain, bleeding, or fever.

Like any other procedure, endoscopic retrograde cholangiopancreatography is not flawless. There is a minor, recognized risk that abnormalities, including cancers, may not be identified at the time of the procedure. It is crucial to continue to seek care from your healthcare providers as instructed and inform them of any new or ongoing symptoms.

Should you need to have an ERCP in Little Rock, AR, our GI specialists can help you select the ideal approach for your healthcare needs.

In certain cases, the alternatives to the ERCP procedure will be dependent upon the underlying reason for needing to undergo an endoscopic retrograde cholangiopancreatography, to begin with. For the majority of individuals, endoscopic retrograde cholangiopancreatography is the best option to evaluate and address irregularities in the pancreatic and biliary structures. However, an imaging technique called magnetic resonance cholangiopancreatography (MRCP), percutaneous transhepatic cholangiogram (PTC), or echo-endoscopy or endoscopic ultrasound (EUS) can also examine the biliary and pancreatic ducts. On a further note, magnetic resonance cholangiopancreatography is only utilized for diagnostics. Addressing any concerns will require an ERCP procedure or surgery. In addition, EUS or PTC do have treatment alternatives.

At GastroArkansas, our team of highly trained GI physicians commonly conducts endoscopic retrograde cholangiopancreatography (ERCP) for Little Rock, AR patients. To identify your options for gastrointestinal care, please contact our practice today.

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