ERCP Procedure
Patient Information
ERCP is a procedure where a flexible tube with a camera is used to check and treat issues in the bile ducts and pancreas. Dr. Webber performs this at Fiona Stanley Hospital and Hollywood Private Hospital.
Endoscopic Retrograde Cholangio Pancreatography -ERCP
In ERCP, under deep sedation or general anaesthesia, a flexible endoscope is inserted via the mouth, through the oesophagus and stomach and into the duodenum. A flexible wire is passed under X-Ray guidance into the bile duct and/or pancreatic duct and contrast agent is injected to allow visualisation of stones, strictures and other abnormalities.
The sphincter muscle at the ampulla can be divided with electricity, a procedure called sphincterotomy. This allows stones to be extracted or stents inserted. Samples of bile and brushings of the lining of the bile duct can be taken for pathology to check for malignancy and infection.
Dr Webber is extensively trained in both ERCP and Upper Gastrointestinal Surgery and has elective and emergency lists at Fiona Stanley Hospital and Hollywood Private Hospital for both ERCP and General / Upper GI Surgery
Planning the Procedure
This is a guide only, individual cases may vary.
You will be seen at the rooms, or given a phone appointment for rural patients if deemed safe. We will discuss the problem and the options for treatment. If a procedure is planned, you will be given a date and admission information on the day. We will discuss risks and benefits of surgery and sign a consent form together. The anaesthetist will contact you for more information and you will be required to fill out an online form for admission at Hollywood.
Contact the rooms if your health changes, you start new medication or to make changes to your booking date.
Any issues contact the rooms or Hollywood Hospital (08) 9346 6000.
Indications
Gallstones can block the flow of bile leading to jaundice. These may be removed surgically along with the gallbladder or with ERCP. Pancreatic and bile duct cancer, and benign inflammatory strictures can block the flow of bile and require ERCP to relieve the obstruction with a stent. Stents can be temporary plastic or wire stents (last ~3 months), or permanent wire mesh stents. Bile duct blockage can also result in infection termed ascending cholangitis, which is a surgical emergency.
Samples are sent to Western Diagnostic Pathology or Pathwest. Severe complications of ERCP include pancreatitis and bleeding at ~1:100 Rare complications such as perforation are far less common.
Aftercare and Follow Up
After ERCP you will be fasting for 2 hours then taking clear fluids only for 4 hours, then taking normal diet at 6 hours. Most complications are apparent soon after the procedure and may delay discharge. If you have unexpected pain after discharge or any signs of bleeding including black stools please contact the rooms / hospital urgently.
If a stent has been inserted we will arrange the next required procedure or follow up date before discharge At follow up we will review findings, pathology results and further management if required.
Your GP will be included on pathology, operation note + correspondence. We will make a plan for restarting medications including blood thinners if required before discharge.