ERCP Questions

Hi - my daughter and I are scheduled for a consultation of the 11th with a gastrologist about her having an ERCP - presumable to see what is causing her pancreatitis or what the damage is.  I have read in this forum that an ERCP can be very tricky and even cause pancreatitis.  For those of you that have been through a consult or an ERCP what questions should I ask the doctor that you may have wished you had asked? You know - those things that you think "well if I had only known".  Thanks for any comments or input

[Lor]

Ask the Dr how many ERCP's does he do in a week or month. You want someone who does a lot and is very experienced.If he is going to do menometry make sure you know before hand. That is an addition to ERCP where the Dr measures the pressure in the bile duct. It's more risky than ERCP alone. Don't feel you have to settle with him if he doesn't do many. It's better to be refered to someone with experienced.

[Baseball_Mom]

I agree with Lor!  Find out how many ERCPs this doctor does per week, in a month, and how many total has he done.  And of that number, how many patients are hospitalized with Pancreatitis.  Also, what part of the country do you live in?  I hear one of the BEST Gastro doctors in the country is in Charleston, SC.  His name is Dr. Peter Cotton.  I had an ERCP done in November and ended up in the hospital for 3 days with Pancreatitis and out of work a month because of it.  My doctor had done about a 1,000 of them total.  This is a very tricky procedure and if they don't do what they are suppose to do with the utmost care, it could be disaster.  Sorry, I didn't want to sound like the bearer of bad news.  Maybe TazLady will post an answer to your questions as well.  I know that she has had several ERCPs done.  So she has way more experience than I do.    If you daughter currently has pancreatitis I would be very cautious about having an ERCP done because of the increased risk of setting off the pancreatitis.  Best of luck to you.

[TazLady]

Hi Squash,
I have had several ERCP's and in fact am having another on 4/10.  Mine are pretty complicated and I can expect to be in the hospital for 4 days or so.  Hopefully no longer than that.
Finding a dr. who is experienced is EXTREMLY important.  My dr. just told me that the ERCP he just did on me was what he considered to be major surgery, without cutting into my belly.  So don't let anyone try to tell you this isn't an important surgery, or let them downplay it.  
I can tell you that the dye they use during an ERCP can/will cause a pancreatic attack.  It put me in the hospital for 9 days.  You can probably expect to be a little sore afterward, tired for a few days and perhaps even have a sore throat.  You should not remember a thing as they will put you completly.  When done correctly, you should be able to have the ERCP and be out of the hospital, if not that day, the day after.  If you are thinking ahead, you may ask to stay in the hospital overnight for the 23 1/2 hour observation, just to make sure that a pancreatic attack does not happen.  I would reccommend this highly. It's much better to be in the hospital if this happened than at home and rush to the ER Room and try to get them to believe you.
There is also a good chance that yours will go smoothly and all you'll end up with is a sore throat.  That happens to many people.
Hope this helped.  Good luck to you.  And once again, if it's at all possible, AVOID the dye they use during the ERCP.
TazLady

[INALOTOFPAIN]

............You dont have to have an ERCP, ask yor doctor for an Transabdominal Ultrasound,if your problem is not severe. HIDA and DISIDA,tests can help your phisican determine if there are stones in the billiary tract, leakage or obstruction as well. Do not settle for having an inexperienced endoscopist do this ERCP on you, the mortality if fairly high due to perforations etc etc.

[Squash]

Thanks for all your posts.  Our appt. is on the 11th.  We live in Dallas, TX for your information.  Will let you know what happened on the consult.  I don't want to do anything that will cause more health problems for her.  As many of you probably know she is the one with Cystic Fibrosis that probably caused her pancreatitis.  She is a college student, Texas A&M just trying to live her life.  Talk to you later.