Inserting a bilary stent with a ERCP
A stent is a plastic or metal tube that is used to unblock the bile duct if it becomes blocked by the tumour. This will relieve your symptoms of jaundice. Metal stents are used more commonly then plastic and are less likely to become blocked. There are a few ways of inserting the stent and your doctors will advise on which method is best for you.
ERCP – Endoscopic Retrograde Cholangio-Pancreatography
This test allows your doctor to look at an image of your pancreas and bile duct via an x-ray. ERCP takes place in the x-ray department in hospitals. The results of this can allow doctors to visualise where your blockage is and treat it appropriately.
You will have a needle inserted in the back of your hand so that you can be sedated. You will then lie on your left side with your left arm behind your back. Your pulse and oxygen levels will be monitored using a probe on your finger, you may be given oxygen if you need it.
Doctors will pass a flexible camera (an endoscope) down your throat and into your stomach. The tube will pass into the first part of your intestine (duodenum) where the bile duct is. The doctor will pass a narrow plastic tube called a catheter down the endoscope and into this opening.
A dye will then be injected through the catheter to visualise your bile ducts and pancreas through the x ray. The dye is completely harmless and will pass out of your body naturally. If the doctor can see a narrowing or blockage to the bile duct a stent can be inserted. If there is anything else unusual on the x-ray, then a biopsy can be taken where a cell sample (brushing) is removed from the ducts to be examined under a microscope.
If you need an ERCP you will need to attend a pre-admission clinic so you can receive information about the procedure and have any blood tests required. If you have diabetes or glaucoma you will need to inform the medical staff once you are aware of your appointment. If you take any medication that acts as a blood thinner i.e. warfarin you will need to inform medical staff as you will need to stop taking them in the days prior to your procedure.
You will be advised about eating and drinking before your ERCP, often people cannot eat or drink (nil by mouth) for around six hours prior to the procedure. You may also be given an antibiotic to prevent infection.
How long does the test take?
An ERCP takes around 30-90 minutes
How will I feel after the test?
You will go back to the ward and a nurse will check your pulse and your blood pressure regularly until you are fully awake. You may feel sleepy for a couple of hours because of the sedation.
After you have been back on the ward for a few hours, if you have abdominal pain, some blood will be taken to check if there has been any irritation to your pancreas (pancreatitis) after your ERCP. If you develop pancreatitis, you will need to stay in hospital until it settles.
If you are allowed home on the same day as the test, then you will need someone to look after you for the next 24 hours. It takes this long for the sedative to leave your system and during this time you must not drive, operate heavy machinery, make any important decisions or drink any alcohol.