It’s Complicated: How a Roux-en-Y Affected My Routine ERCP

It’s Complicated: How a Roux-en-Y Affected My Routine ERCP
I had almost three years of perfect health following my liver transplant until my liver enzymes tripled in May. An abdominal ultrasound and liver biopsy showed no abnormalities. However, a magnetic resonance cholangiopancreatography found slight dilation of my common bile duct. My transplant team initially decided to monitor my bloodwork before conducting an invasive procedure. In late August, I met with Dr. William Stassen, my gastroenterologist, to discuss my colonoscopy. The day before, he and my transplant hepatologist had spoken about my worsening liver function. They agreed to have Dr. Stassen’s colleague, Dr. Binh Pham, perform an endoscopic retrograde cholangiopancreatography (ERCP) immediately. What is an ERCP? Inflammatory bowel disease (IBD) patients are at high risk of developing disorders of the pancreas and the biliary tract, which includes the liver and the gallbladder. To diagnose and treat these conditions, a gastroenterologist guides an endoscope — a camera attached to a flexible tube — through the patient’s mouth, esophagus, stomach, and small intestine. The doctor injects dye through a catheter to view pancreatic or biliary ducts by X-ray. The flow of the dye can indicate pancreatic disease, gallbladder inflammation or stones, and biliary conditions. The gastroenterologist can insert tools into the scope to crush and remove stones in the bile ducts or gallbladder. The doctor can also collect tissue samples or perform a biopsy. In my case, Dr. Pham widened my biliary duct stricture with balloons and a stent. I had my first ERCP in 1997 to diagnose and treat primary sclerosing cholangitis (PSC). Until I changed gastroenterologists in 2006, I had ERCPs almost yearly so my doctor could evaluate the progression of my disease and plac
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  1. Joyce Kossey says:

    I am curious-do you know what sedation medication they gave you? Did they give you an explanation of why you felt so differently after this procedure as opposed to previous experiences?

    • Thanks for your questions! According to my insurance estimate of benefits, I was given propofol. When the doctor called me the day after, I asked about the achiness in my back and abdomen, and he said it was normal from all the stretching and manipulation they had to do. I was still quite groggy from the anesthesia and hoarse from the procedure, so I wasn’t able to ask as many questions as I would have liked. I’ll try to learn more the next time I speak to him.

    • Hello again! So, I just had the procedure repeated a couple of weeks ago to remove the balloons. It was a much more pleasant experience, and I didn’t have the abdominal pain like before. I haven’t gotten my EoB, yet, to see what anesthesia they used. However, the anesthesiologist injected a painkiller in my IV before starting the anesthesia drip. I immediately felt loopy and don’t even remember her telling me to start counting before falling asleep, ha ha.

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