Stones removed by endoscopy, then gallbladder removal.

Tom_Peters linda17563 · 2015-07-15T12:52+00:00

I had an ERCP which is the endoscopy and removal of stones exactly a week ago as a day-case patient. I've had many endoscopies before but not ERCP and for me I don't like the first bit when the camera goes down; once it's past the gagging point I'm fine. Having said that, on a scale of 1 to 10 in horrible-ness it isn't much more than a two! I was given a sedative (midazolam) and a strong opioid analgesic (pethidine) and I wasn't aware of much of it and certainly no pain. For this procedure they use an X-Ray to guide a small cannula that goes up the common bile duct (CBD) To do that they go down to the duodenum and locate a little orifice (a sphincter, like the one in one's anus) and usually they cut and cauterise it to gain better access and to make it easier for stones to pass in the future. Once through the sphincter into the CBD they squirt some contrasting fluid in which looks opaque to X-Rays. In my case they didn't find the stones - sometimes they have passed before the procedure or just possibly the blockage might be due to the pancreas putting pressure on the CBD. They cleaned out the CBD with a little brush and then came out again. I was in for 30 minutes which seemed like five minutes and was fully awake before we left the procedure room -- they were VERY surprised, said normally people were still under for quite a while so presumably the sedation was light for me.

I had to wait a couple of hours before they'd let me eat and I was watched carefully and monitored every 15 mins or so. The endoscopist came round to see me and had a chat, she was very pleased and said I could leave an hour earlier than usual. My wife drove me home.

Since then I have had no gallstone pain but I haven't re-gained my appetite, with my weight falling around 250g per day feeling a bit nauseus. I don't think it's anything to do with the procedure but obviously more bile is coming down now and maybe that has had an effect? I fear that it is something else related but not actually to do with gallstones. They were talking about having my gall bladder removed and I will see the consultant in a couple of weeks.

There are known complications which you need to understand before the procedure. Infection leading to acute pancreatitis is the most common and is said to be horrid. Perforated bowel or CBD is another possibility as is mistaking the pancreatic duct for the CBD. Some people apparently have a reaction to the contrasting fluid.

All in all unless you get one of the complications there is nothing to fear. Good luck, if they want to do it, it will be because they need to not because they have nothing better to do!

heepee linda17563 · 2015-07-16T15:35+00:00

Hi Linda ,

i had both of these procedures . My advice would be :- after the ERCP do not eat any fat whatsoever and try to push to have the gall bladder removed asap . I wrongly thought after the ERCP that as they had done a syhincterotmy at the same time , that this meant any future stones would just flow out . The fat in your diet makes the gall bladder move , which makes the stones move , which can still get stuck in your cystic duct Or the bile duct or in my case both , which can then lead to a whole host of problems .

i was most worried about the ERCP , but really both procedures were fine , it was in between the 2 procedures that I had the most problems . But I'm sure that I was atypical and that after you have had the ERCP you will be fine until your operation .

Stones removed by endoscopy, then gallbladder removal.

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Thanks for your help!