The procedure is usually carried out under conscious sedation. This is not a general anaesthetic therefore you will not be asleep, the sedative will help to relax you but you will still be able to feel sensations, hear what we say to you and be able to follow simple instructions during the test. You may not remember anything because of the medication but this cannot be guaranteed. You will be able to breathe normally throughout. During the procedure we will check your breathing and pulse rate and you will be given oxygen throughout the test. The sedation can stay in your system for up to 24 hours so you are not allowed to drive, drink alcohol, operate machinery, sign legal documents or look after small children.
You need a responsible adult to take you home and stay with you for the next 24 hours.

Some patients may have to stay overnight following their procedure but most will be able to go home on the same day. We may not be able to tell you if you will need to stay in until the day of the procedure. You should arrange for someone to be available to collect you from hospital in the event that you can go home. Please bring an overnight bag with you and any medication you are currently taking in the event you need to stay in hospital.

These complications are rare but may be serious enough to require urgent treatment and even an operation. Death is a remote possibility, but this is rare.

• Breathing difficulties or heart irregularities as a result of reacting to the sedation. To help prevent this from happening, your oxygen levels and heart rate will be monitored. Rarely, a heart attack or stroke can happen if you have serious medical problems.
• Pancreatitis – inflammation of the pancreas.
• Diclofenac suppositories in ERCP
  We know that ERCP is associated with risk of pancreatitis in about 3-5% of patients. There is now evidence to suggest that using a single dose of an anti-inflammatory drug can reduce the risk. It is given as a suppository (into the back passage) following your procedure. As with any anti-inflammatory drug the potential side effects of this drug are on the gut or kidneys. It can cause ulcers in the gut or can affect the kidneys. However evidence suggests that benefits of using a single dose of this medication outweigh the potential risk and therefore it is recommended. It will not be used if you are known to have allergies with anti-inflammatory drugs or actively bleeding.
• Cholangitis – infection of the bile duct.
• Perforation – Making a hole in the oesophagus, stomach, bowel or other organ during the procedure. This is a serious complication, you may need surgery.
• Bleeding – from a biopsy site or from minor damage caused by the endoscope. This usually stops on its own.
• Incomplete procedure – This can happen due to a technical difficulty, blockage in the tract, complications during the procedure or discomfort. Your doctor or the endoscopist may recommend another or a different test.

Surgical operation under General Anaesthetic.

• Pre-assessment
  Most patients are pre-assessed over the phone by an endoscopy nurse prior to their procedure.  On occasion this may be done face to face on the endoscopy department.
• Blood tests
  You may need to have some blood tests done before your appointment. Please make sure that you read the information booklet in conjunction with your appointment letter so that you know when to have your blood tests.
• Conscious Sedation
  You need to ensure you have a responsible adult to collect you from hospital on the day of your procedure and stay with you for 24 hours. If you are unable to arrange this you should contact the Endoscopy Department.
• Interpreters
  Please inform the Endoscopy Unit if you require an interpreter prior to your appointment day. Failure to do this can result in delay or cancellation on the day. Family and friends cannot be used to interpret; a professional interpreter must be present.
• Pacemakers, implanted defibrilator or other electromechanical devices
  If you have a pacemaker or other electromechanical device this may need to be checked before your procedure. You should inform the Endoscopy Unit as soon as possible. Failure to do this can result in delays or cancellation on the day. Please bring your pacemaker identification card with you.
• Allergies
  If you have any allergies please inform a member of the nursing or medical team.
• Medication
  If you are taking medication to ‘thin’ your blood e.g. Warfarin, Clopidogrel, Rivaroxaban, Dabigatran or other blood thinning medication. Your pre-assessment nurse will advise you about any adjustments that need to be made. It is important to follow these instructions as not doing so, may lead to your procedure being cancelled.
• Diabetics
  Patients with diabetes will need to adjust or omit their diabetic medication prior to their procedure. The medical or nursing team looking after you will give you advise about your diabetes medication.
• Other medication
  You may take any other necessary medication as normal with a small amount of water. This is particularly important if you take medication for epilepsy or high blood pressure (hypertension) as your test could be cancelled if your blood pressure is too high. You should receive a form with your appointment asking you to list your medication. If you have any difficulty completing this form, please ring your GP surgery for assistance as they should have a record of your current medication.
• Consent
  You have been sent a copy of the consent form please take the time to read the form so that you understand fully what you are consenting to.
  If you are caring for someone who is unable to give consent for the procedure themselves, you will not be able to sign the consent form for them.  Your consent form will be completed with the Endoscopist prior to your procedure.

Your stomach needs to be empty to allow clear views of the lining of your stomach and bowel and also to prevent vomiting during the procedure. This is very important as vomiting during the procedure could allow fluid to enter your lungs.