Cholangiopancreatography, Endoscopic Retrograde
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To visualize and assess the pancreas and common bile ducts for occlusion or stricture.
There are no activity restrictions unless by medical direction. Instruct the patient to fast and restrict fluids for 4 to 8 hr, or as ordered, prior to the procedure. Fasting is ordered because an empty stomach provides better visualization and as a precaution against aspiration related to possible nausea and vomiting. The American Society of Anesthesiologists has fasting guidelines for risk levels according to patient status. More information can be located at www.asahq.org. The patient may be instructed to prepare the bowel with a laxative or enema the night before or morning of the procedure, by medical direction.
Note: If iodinated contrast medium is scheduled to be used in patients receiving metformin or drugs containing metformin for type 2 diabetes, the drug may be discontinued on the day of the test and continue to be withheld for 48 hr after the test.
Patients with heart valve disease may be premedicated with antibiotics.
Regarding the patient's risk for bleeding, the patient should be instructed to avoid taking natural products and medications with known anticoagulant, antiplatelet, or thrombolytic properties or to reduce dosage, as ordered, prior to the procedure. Number of days to withhold medication is dependent on the type of anticoagulant. Note the last time and dose of medication taken.
Patients on beta blockers before the surgical procedure should be instructed to take their medication as ordered during the perioperative period. Protocols may vary among facilities.
Ensure that this procedure is performed before an upper gastrointestinal (GI) study or barium swallow.
- Normal appearance of the duodenal papilla
- Patency of the pancreatic and common bile ducts.
Critical Findings and Potential Interventions