SAGES Magazine

THE SOUTH AFRICAN GASTROENTEROLOGY REVIEW 2022 | VOLUME 20 | ISSUE 3 | 67 ERCP | A GUIDE FOR NURSES AND ASSISTANTS | Re-printed with permission PO S T E R C P WHA T T O T E L L T H E PAT I E N T WH E N T H E Y GO HOME When the patient leaves theatre they go through the usual post procedure checklist for anyone that has received sedation, with particular emphasis on the possible complications associated with ERCP, so: ensure fluids are running, monitor pulse and blood pressure and follow any instructions regarding antibiotics . The patient is usually given a copy of the ERCP report to go home with, and I hope this booklet so far has enabled you to have an informed discussion with the patient if they wish to talk through their procedure. After the usual interval, the patient is offered something to eat and drink, and, in 95% of cases are free to go home 6 hours post procedure or go back to the ward more immediately. In most cases, no further procedures are required, but if a stent has been left after incomplete stone removal, or readmission is planned to remove pancreatic or temporary stents, this should be made clear on the report. Temporary stents may fall out of their own accord and pass through the bowel - they may be noticed in the toilet by the patient, and in most cases this is not a concern, but worth noting in case the patient is required to re-attend for an endoscopy to remove the stent which has fallen out. In any case a plain Xray of the abdomen is usually carried out beforehand to avoid unnecessary endoscopies. The risk of bleeding for up to 7 days post sphincterotomy has been mentioned already and should be re-emphasised to the patient on discharge. Stents may block, and stones may have been missed as well, so any recurrence of pain or jaundice should be reported back to the endoscopy department, or the operator via their secretary. In case of emergency, however, the GP should be informed and arrange review or admission as required. Often, the patient will ring the department and review can be arranged if necessary (in RGH - please let the ERCPist know and the patient can be reviewed in the Ambulatory Care Unit). 41