Endoscopic Retrograde Cholangiopancreatography (ERCP) in Lubbock, TX

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Lubbock Digestive Disease Associates offers endoscopic procedures to assess several types of gastrointestinal diseases and conditions. An ERCP, or endoscopic retrograde cholangiopancreatography, is an endoscopic process where a long, slender tube or “scope” is inserted into the oral cavity and gently advanced to the first portion of the small intestine. The tube is fitted with a light and a camera on the end of it that lets the provider view the lining of the esophagus, stomach, small intestine, the entrance to the bile duct, and the pancreatic duct. An endoscopic retrograde cholangiopancreatography assessment may be needed to detect the reason for gastrointestinal issues, such as:

  • Abnormal liver test
  • Pancreatitis
  • Abnormal x-ray results
  • Pain in the abdominal area

Please get in touch with one of our Lubbock, TX locations today to request a consultation with a gastroenterologist to find out more about an ERCP procedure and if it is right for you.

What are the benefits of an ERCP?

An ERCP may be advised if blood tests show abnormal liver results, if you have inflammation of the pancreas, or if you experience symptoms such as abdominal pain or yellowing of the eyes and skin. Some benefits of an ERCP procedure are:

  • Diagnostic and therapeutic: This approach may serve dual objectives, helping physicians detect diseases or conditions and conduct treatment during the same process. As such, this can lessen the need for multiple appointments.
  • Short recovery times: Individuals often experience quicker recovery times with an ERCP as opposed to conventional approaches involving surgery, facilitating an expedited return to normal daily activities.
  • Enhanced precision: An ERCP helps enable the precise treatment and visualization of the biliary and pancreatic ducts. This is imperative for precision diagnosis and treatment.
  • Efficiency: The opportunity to identify and treat a health issue within a single procedure often minimizes the total treatment time for patients.

You will be given instructions from your provider at your local Lubbock Digestive Disease Associates regarding the necessary preparation. In most situations, you can eat as you normally do the day before the exam. Patients will be advised not to eat or drink anything after midnight with the exception of any medications. It is crucial to follow the directions provided by your provider. Further information regarding your medications may be given. In most circumstances, your medications will be continued as usual. However, in patients taking anti-coagulants, (for example anti-inflammatories, aspirin, Coumadin®, Plavix®, and warfarin) and with diabetic patients, special instructions will be provided.

You will need to arrive at the endoscopy center in Lubbock, TX 1 – 1.5 hours before your ERCP procedure. This is to allow time to complete paperwork and prepare for your ERCP. Once you have changed into a medical gown, our clinical team will place an intravenous (IV) line in your arm to allow sedation to be given. Special equipment will be used to enable the provider and staff to monitor your pulse, heart rate, blood pressure, breathing oxygen, and electrocardiogram levels throughout and after the exam.

After you enter the exam room, you will lie down on your stomach on the stretcher, and IV sedation will be administered. It will be provided in small doses to ensure that you do not have a reaction to the medication and only the amount you need is administered. In comparison with other endoscopic tests, it is not atypical for general anesthesia to be administered for this exam. After an adequate level of sedation is established, the endoscope will be carefully entered into the mouth. The device will be carefully moved through the esophagus and down into the stomach and small intestine to where the pancreatic duct and bile duct opens into the small intestine. A small pocket of air is administered via the endoscope into the digestive system to help the specialist see. During this procedure, contrast dye is introduced into the biliary and pancreatic ducts. An x-ray imaging machine is used to take images of the bile duct and pancreatic duct to identify whether there are any abnormalities. Any residual fluid in the upper GI tract can be suctioned out with the scope. Based on what the procedure reveals, a few things may be done during the test, including tissue extraction for a biopsy, stent placement into the bile or pancreatic ducts, sphincterotomy (opening the bile or pancreatic duct), and the removal of gallstones from the bile ducts or stones from the pancreatic ducts. When the procedure is complete, as much of the air and remaining fluid as possible will be suctioned out through the endoscope device. Each ERCP assessment takes about 30 – 90 minutes, depending on the findings.

After the exam has concluded, you will be escorted to the recovery area to be monitored while the sedation medication begins to subside. The portion of sedation given during the test and how you respond to the medication will affect how soon you wake up; however, most patients are alert enough for release within 45 – 60 minutes. You cannot operate any vehicles for the remainder of the day; therefore, you should arrange for a ride home in advance. You will also be advised not to sign important papers, engage in strenuous activity, or work for the rest of the day. The majority of people can eat and drink as usual after being discharged from the endoscopy unit, though important instructions regarding eating, activity, and medications will be administered before release. Occasionally, patients might need an overnight hospital stay for evaluation.

Following the exam, the specialist and/or clinical staff will discuss the findings of the procedure with you. The majority of patients will not recall the information provided in the wake of the ERCP process because of the effects of the sedation. Our Lubbock Digestive Disease Associates staff highly recommends you to have someone accompany you to whom the outcomes can also be shared with, if possible. You will also be provided with a typed synopsis and will be contacted with any test or biopsy results usually within one week.

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Endoscopic retrograde cholangiopancreatography is generally a very safe procedure. The majority of complications are not life-threatening; however, if a complication occurs, it might lead to surgery and hospitalization. Before beginning the procedure, a consent form will be explained to and reviewed with the patient by the nursing team. Treatment risks will once again be explained by the doctor before the procedure initiates, and any questions or concerns can be addressed.

Acute pancreatitis, or inflammation of the pancreas, is the most common complication. The condition can impact 5 – 8% of individuals. However, depending on the person, the risk can run as high as 20%. Pancreatitis signs and symptoms often include nausea, vomiting, pain in the abdominal area, and possibly fever. The majority of pancreatitis cases are not severe and require a hospital stay of four days or less. While hospitalized, patients typically only need pain and nausea control along with IV fluids. In very few cases, however, pancreatitis can be more serious and can even be life-threatening.

Reactions from the sedation medication can arise. These reactions can include but are not limited to, difficulty breathing, effects on blood pressure and the heart, irritation of the vessel used to administer the sedative, and allergic reactions. Bleeding can occur with a sphincterotomy or biopsies. Major bleeding, like that which may indicate a blood transfusion or a hospital visit, is not a common occurrence.

Perforation or puncture of the esophagus, stomach, or small intestine can also occur. This could be identified during the procedure, or it may not be discovered until later. The majority of the time, a puncture of this type will lead to surgery and a hospital stay. Though, this is a highly uncommon complication, even when biopsies or a sphincterotomy is performed.

Finally, in 5 – 10% of people, the endoscopic retrograde cholangiopancreatography assessment may not be able to be carried out for a number of reasons. It is extremely important that you contact your provider's office immediately if any symptoms develop after the procedure, such as bleeding, increasing abdominal pain, or fever.

As with any other test, ERCP is not perfect. There is a small, acknowledged risk that health concerns, including cancers, go undetected during the exam. It is vital to continually visit your medical providers as instructed and inform them of any new or ongoing symptoms or concerns.

Should you find yourself needing an ERCP in Lubbock, TX, our GI specialists can help you identify the optimal options for you.

In some instances, any alternative options to the ERCP procedure will depend on the reason an endoscopic retrograde cholangiopancreatography is being done in the first place. For the majority of patients, ERCP is the best option to examine and treat certain problems in the biliary and pancreatic structures. However, an x-ray known as a magnetic resonance cholangiopancreatography (MRCP), percutaneous transhepatic cholangiogram (PTC), or echo-endoscopy or endoscopic ultrasound (EUS) can also examine the bile and pancreatic ducts. Magnetic resonance cholangiopancreatography is only used for diagnostics. Treatment of abnormalities will involve an ERCP or surgery. Moreover, PTC or EUS do have treatment alternatives.

What questions might be helpful to ask your doctor about the ERCP procedure?

If you discover that you need an ERCP, you will probably have several questions or concerns and might not know where to begin. A few questions to ask your GI physician may include:

  • What does your physician expect to find during this process?
  • What is the overall success rate of an ERCP?
  • If a complication should arise, are there any symptoms or signs you might notice?
What should you avoid doing after undergoing an ERCP?

You should not drive for 24 hours following an ERCP procedure as the anesthesia might take that long to fully leave your body; therefore, you will need to have a family member or friend plan to drive you home from your procedure. You may be instructed to avoid eating for a period of time depending on the treatment conducted during the course of the ERCP. Our team may also suggest taking the rest of the day and potentially the next day off work to recover. Your Lubbock Digestive Disease Associates team can provide information on what to anticipate throughout the course of the ERCP procedure.

What procedures can be performed during an ERCP?

Some of the more common treatments performed during the course of the ERCP process involve:

  • Stent placement (pancreatic and biliary ducts)
  • Biopsies (tissue sampling)
  • Removal of stones (gallstones in the bile duct)
  • Sphincterotomy (of the biliary sphincter)
How might I prepare for an ERCP?

Our Lubbock, TX gastroenterology team will give you information on how best to prepare for an ERCP procedure. However, a few instructions you might be advised to follow are:

  • Do not eat or drink for eight hours before your ERCP procedure. (Water may be okay to drink. Ask your physician for confirmation.)
  • Do not smoke for eight hours before your ERCP appointment.
  • Give your GI physician a list of medications you are currently taking along with any known allergies you may have.

At Lubbock Digestive Disease Associates , our team of experienced GI providers routinely perform endoscopic retrograde cholangiopancreatography (ERCP) for Lubbock, TX patients. You do not have to live in wonder about what is causing your troubling symptoms. To further explore the type of gastrointestinal options you have, please contact one of our locations today.

I've been seeing Dr Rakvit due to health issues lost count of how many years she has taken very well care of me I will continue to see you as long as I can

B.E. Google

All great! First time to see Dr Rakvit. She had already reviewed my history (long history) and knew what I needed!

G.B. Google

Dr. Rakvit is extremely approachable and personable. I have been suffering for over 15 years with a condition that I had accepted as just the way it is. But x I was referred to Dr. Rakvit and she listened to what I was saying a n d took steps to correct my condition. Life is good again.

B.H. Google

Very friendly and didn't have a long wait !

J.R. Google

1st time I have ever had a scope but for what needed to be done LDDA took really good care of me. I wish there was an easier way to prep, that was honestly not fun but the procedure itself, I was put out and in no pain. The staff was excellent and I was negative and good for another 10 years. Gastroenterologist Dr. Arwin Rackvit took really good care of me during the procedure. I really appreciate her and the staff. Thank you again for the great care. Virgina Peek

J. Google

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