Description

ERCPs were preformed in the Radiology Department 8 years ago under the Fluoroscopy system. The procedure has since been shifted to the Endoscopic Department on the 3rd level at SMC.
ERCP is a valuable examination for the diagnosis of many diseases of the pancreas, bile ducts, and gallbladder. ERCP allows the doctor to perform necessary treatments such as dilating the CBO, removing gallstones lodged in the bile duct, inserting a stent (drain) in the duct or taking a biopsy specimen (tiny bit of tissue).

Procedure

A flexible fiberoptic/video tube (duodenoscope) is passed through the mouth, esophagus (food tube) and stomach into the duodenum (second part of the small intestine). The ampulla (opening where the bile and pancreatic ducts empty into the duodenum) is then identified. 
 A small plastic tube (canula) is passed through the duodenoscope into the ampulla. X-ray dye is injected through the canula into the ducts. With the help of X-rays fluoroscopy system images are taken for the study of the ducts. Any necessary treatments can be performed at this time.
Patients should remove dentures and eyeglasses prior to the start of the procedure. They are asked to sign a consent form authorizing the doctor to perform the procedure. Patient should tell the doctor or the GI nurse if he/she is allergic to any medicines or X-Ray Contrast media.

A needle for intravenous (IV) medicines and fluids will be placed in the patient's arm vein. Medicine will be injected through the IV needle that will make the patient sleepy and relaxed. The doctor may spray the patient's throat or ask him/her to gargle with a numbing medicine.

The patient will lie on an x-ray table on his/her left side and a small plastic mouthpiece will be placed between his/her teeth. The patient will be able to breathe normally. The doctor will help him/her to swallow the lubricated flexible duodenoscope tube. When the tube is present in the duodenum, the patient will be helped to turn onto his/her abdomen with his/her head turned to the right.

During the procedure, the patient may feel some abdominal fullness or bloating due to the air which the doctor puts into the duodenum. As the x-ray dye is injected into the ducts, the patient may feel some mild discomfort. These feelings should be completely tolerable and not painful. ERCP takes 30 minutes to 2 hours. After the procedure, the patient will need to stay at the hospital for 1 to 2 hours until the sedative wears off.

After the duodenoscope is removed, the patient may be asked to move into various positions so that more x-rays can be taken.

Many people do not recall any of the procedure because of the effect of the medicine. After the procedure the patient will probably feel drowsy and may sleep for a short time.

Approximately 89 routine ERCP procedures are performed annually at SMC using the mobile C. arm fluoroscopy unit in the endoscopic department.

Precautions

Scanning is NOT allowed for pregnant women.

Location and Contact

The Endoscopy suite at SMC is located on the 3rd floor - New Building. The suite currently has 3 procedure rooms. Only one of these rooms is allocated for ERCP as it is shielded.

Dir. Tel. No.: 17284675

Ext. No.: 4675 -4677

Equipment

This unit has state-of-art facilities, such as the mobile C. arm fluoroscopy unit (manufactured by Philips) and the endoscopic equipments which are used in ERCP procedures.

Available Staff

We usually send one Radiographer to cover the examinations.

One Consultant Physician & Gastroentrologist:

Dr. Jehad Radhi Al-Qamish, MBCh. MRCP (UK), FRACP

Endoscopy nurses:

Sister Majeda & Sister Kawakab

Timing

Mondays only from 7:00 AM to 2:00 PM
At present there are no facilities available to perform the procedure other than during daily working hours due to lack of manpower.

In case for emergency we will arrange one radiographer to work with ERCP team.