Surgery

Why It’s Done (Indications) 

Combines endoscopy and X-rays to diagnose and treat problems in the bile ducts and pancreatic ducts, such as gallstones lodged in the main duct, blockages, jaundice, or duct leaks.

How to Prepare (Preparations)

• Medications: Inform your doctor about any blood thinners or diabetes medications, as they may need temporary adjustment.
• Strict fasting for 6 hours before the procedure.
• Blood tests evaluating liver function and blood clotting are reviewed prior to the intervention.
• Antibiotics and rectal medications (Non-steroidal anti-inflammatory drugs) may be given prior to the procedure.
   

What Happens (Procedural Details)

1. Performed under deep sedation or general anesthesia.
2. A specialized side-viewing endoscope is guided down into the duodenum where the bile duct opens (the papilla).
3. A small plastic tube (catheter) is inserted through the scope into the duct, and contrast dye is injected to highlight the ducts on X-ray images.
4. Using tiny instruments, the doctor can cut the duct opening (sphincterotomy), extract gallstones, or place a plastic/metal stent to bypass blockages.
    

Recovery (Postoperative Care)

• Close observation in recovery for 30 – 60 minutes to monitor for abdominal pain or inflammation.
• Stick to a light diet for 24 hours once permitted by your medical team.
• Blood tests may be checked before discharge.
   

Risks (Potential Complications)

• Pancreatitis (inflammation of the pancreas), occurring in < 5% of cases but can be very severe.
• Infection in the bile ducts (cholangitis).
• Bleeding or perforation from cutting the duct opening.