ERCP (Endoscopic Retrograde)

What is ERCP (Endoscopic Retrograde Cholangiopancreatography)?

ERCP is a specialized technique used to study the ducts (drainage routes) of the gallbladder, pancreas and liver. An endoscope (flexible thin tube that allows the physician to see inside the bowel) is passed through the mouth, esophagus and stomach into the duodenum. After the opening to ducts from the liver and pancreas is identified, a catheter is passed through the endoscope into the ducts. Contrast material is then injected gently into the ducts and x-ray films are taken.

What preparation is required?

It is necessary to have a completely empty stomach for the best possible examination. You will therefore be asked to fast prior to the procedure. An allergy to iodine or seafood is not a contraindication to ERCP, but it should be discussed with your physician prior to the procedure. The physician performing the procedure should be informed of any medications that you take regularly, any heart or lung conditions (or any other major diseases), and whether you have any drug allergies.

You will be sedated, therefore you will need to arrange to have someone accompany you to the facility, be available at the facility and drive you home after the procedure. Because sedatives temporarily affect your judgment and reflexes, you will not be allowed to drive or operate heavy equipment for the remainder of the day.

What can be expected during ERCP?

Your physician will discuss why ERCP is being performed, potential complications of ERCP, and alternative diagnostic or therapeutic tests that are available. A local anesthetic may be applied to your throat and an intravenous sedative will be given to make you more comfortable during the test. Some patients also receive antibiotics before the procedure. The test begins with the patient lying on his left side on an x-ray table. The endoscope is passed through the mouth, esophagus, and stomach into the duodenum. The instrument does not interfere with breathing. Air is introduced through the instrument and may cause temporary bloating during and after the procedure. The injection of contrast material into the ducts rarely causes discomfort.

What are possible complications of ERCP?

ERCP is generally a well-tolerated procedure when performed by physicians who have had special training and experience in this technique. Localized irritation of the vein into which medications were given may cause a tender lump that may last several weeks. The application of heat packs or hot moist towels to the area may ease the discomfort.

Major complications requiring hospitalization can occur but are uncommon during diagnostic ERCP. They include serious pancreatitis and even more rarely infections, bowel perforation, or bleeding. Another potential risk of ERCP is an adverse reaction to the sedative used. The risks of the procedure varies with the indications for the test, what is found during the procedure, what therapeutic intervention is undertaken, and the presence of other major medical problems (heart or lung diseases). Your physician will discuss potential complications before you undergo the test.

If therapeutic ERCP is performed (cutting an opening in the bile, stone removal, dilation of a stricture, stent or drain replacement) the possibility of complications is higher than with diagnostic ERCP. Complications include pancreatitis, bleeding, and bowel perforation. These risks must be balanced against the potential benefits of the procedure and the risks of alternative surgical treatment of the condition. Often these complications can be managed without surgery, but occasionally they do require corrective surgery.

What can be expected following ERCP?

If you are having ERCP as an outpatient, you will be kept under observation until most of the effects of the medications have worn off. You will be monitored for any complications from the procedure. Hospitalization may be advised if further observation is necessary. You may experience bloating or pass gas because of the air introduced during the examination. You may resume your usual diet unless you are instructed otherwise. Hospitalization may be advised, particularly if you undergo sphincterotomy (internal incision).

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The young man who registered me was excellent. I waited about 45 minutes and could not help but overhear how calmly and professionally he handled multiple complaints by walk-in patients. The complaints were not related to appointments but getting a response to inquiries about other issues. He just took it all in stride and seemed to calm the patient. Dr. Jones also patiently listened to my personal issues with communications with the practice. I appreciate his time and consideration.

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I would like to write a raving review for Sal! Over the years she has been EXTERMLY professional, her dedication to your patients goes above and beyond. She has been truly a pleasure to work with and we will miss her referring to use here at Michigan Medicine. I have often referred to her process and professionalism with many other outside referring offices. She will be missed! You I wish you nothing but the best Sal!!! Suzanne

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Great experience all-around! Very friendly staff and knowledgeable providers (both physician assistants and doctors) I see lots of people on here who are frustrated with phones and IT-related issues but as this is out of the employee’s hands I base my review off of the things that WERE in their control. They were kind, efficient and understanding.

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From my very first encounter at the front desk, to the discharge nurse after surgery, my experience was a good one. The staff all listened to my questions and concerns, and Dr. Julian is top-notch.

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Our Doctors

We’re proud of our team here at Digestive Health Institute. Our health care providers include some of the very best colorectal surgeons, gastroenterologists and physician assistants. To learn more about our qualified team of specialists, click their image or visit our providers page.

Radoslav Coleski, MD, PhD

Dorian Jones, MD

Lucas Julien, MD

Razvan Opreanu, MD

Scott Plaehn, DO, FACOI

Albert Ross, MD

John Walling, Jr., DO, FACOI

Siaka Yusuf, MD

Our Locations

FAQs

What happens during my first visit?
If you are a new patient, you can expect to have a complete physical exam. You will also be asked detailed questions about your current problems and your past medical history, your current medications, allergies, your family history and other pertinent medical information. If you are taking medications, please bring a completed medical history form with you to your appointment. Once the physician has reviewed your medical information and completed the physical examination, a plan of care will be developed. You may need to be seen again in the office, be referred back to your family physician for follow-up care, or require additional testing. If additional tests are needed, we will assist you in scheduling these tests.
What if I need to schedule an endoscopic procedure?
An endoscopic procedure allows the physician to visualize a part of your gastrointestinal tract with a special instrument called an endoscope. If your family physician has ordered testing, you will be contacted by telephone by one of our staff members. If an Digestive Health Institute physician orders testing and you are in the office, the procedure can generally be scheduled during the course of your visit. You will be given a date, time, and location for the test, as well as written instructions telling you how to prepare for the test. If you have any questions about the procedure, please feel free to ask one of our staff members or the physician.
How do I get test results?
We ask that you wait 10 to 14 days before contacting us for results. Often results come from several different sources. This information needs to be compiled and reviewed by your physician before you can be appropriately advised. You may call 517-332-1200 and press “8″ and your call will be directed to the triage nurse.
What insurances do you accept?
Digestive Health Institute accepts payment from most insurance companies including Medicare, Blue Cross/Blue Shield, Blue Care Network, Physicians Health Plan, Cofinity, Sparrow Professional Health Network, Medicaid, McLaren, Health Plus, and several others. Accepted insurances are subject to change at any time without notice.

If your insurance requires an authorization from your primary care physician, you may be asked to assist us in obtaining this authorization.

All patients are responsible for all copays and deductibles at the time of service.

If you have any questions regarding your benefits or insurance coverage, please contact our Billing Department at 517-332-1200 #6.

What if I need to contact the doctor?
To contact your doctor during business hours please call our main number 517-332-1200. If you have an urgent need to speak with the doctor after hours please call our answering service at 517-483-9124 and the doctor on call will be paged. In the case of a medical emergency please proceed directly to the nearest hospital emergency room.

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