Has anyone had stones removed by endoscopy? (camera down) and what to expect...full gallbladder removal later (stones in there as well) oh joy!
I had an ERCP which is the endoscopy and removal of stones exactly a week ago as a day-case patient. I've had many endoscopies before but not ERCP and for me I don't like the first bit when the camera goes down; once it's past the gagging point I'm fine. Having said that, on a scale of 1 to 10 in horrible-ness it isn't much more than a two! I was given a sedative (midazolam) and a strong opioid analgesic (pethidine) and I wasn't aware of much of it and certainly no pain. For this procedure they use an X-Ray to guide a small cannula that goes up the common bile duct (CBD) To do that they go down to the duodenum and locate a little orifice (a sphincter, like the one in one's anus) and usually they cut and cauterise it to gain better access and to make it easier for stones to pass in the future. Once through the sphincter into the CBD they squirt some contrasting fluid in which looks opaque to X-Rays. In my case they didn't find the stones - sometimes they have passed before the procedure or just possibly the blockage might be due to the pancreas putting pressure on the CBD. They cleaned out the CBD with a little brush and then came out again. I was in for 30 minutes which seemed like five minutes and was fully awake before we left the procedure room -- they were VERY surprised, said normally people were still under for quite a while so presumably the sedation was light for me.
I had to wait a couple of hours before they'd let me eat and I was watched carefully and monitored every 15 mins or so. The endoscopist came round to see me and had a chat, she was very pleased and said I could leave an hour earlier than usual. My wife drove me home.
Since then I have had no gallstone pain but I haven't re-gained my appetite, with my weight falling around 250g per day feeling a bit nauseus. I don't think it's anything to do with the procedure but obviously more bile is coming down now and maybe that has had an effect? I fear that it is something else related but not actually to do with gallstones. They were talking about having my gall bladder removed and I will see the consultant in a couple of weeks.
There are known complications which you need to understand before the procedure. Infection leading to acute pancreatitis is the most common and is said to be horrid. Perforated bowel or CBD is another possibility as is mistaking the pancreatic duct for the CBD. Some people apparently have a reaction to the contrasting fluid.
All in all unless you get one of the complications there is nothing to fear. Good luck, if they want to do it, it will be because they need to not because they have nothing better to do!
Thank you very much for this detailed account...it is my sister having the procedure, and is quite worried....I will read this to her, so she knows what to expect
. She has got to the point where she is frightened to eat because of chest pain and bloating.....this all came about out of the blue a few weeks ago after being prescribed Methotrexate for Arthritis...she was very ill afterwards and this has been the result of the xrays/MRI`s....so she really is not feeling well!!...We can only hope she dosen`t have a long wait for the endoscopy! Thanks again...
I know exactly how your sister feels about eating and bloating with pain! Try to eat nearly zero fat. It is fat by that sphincter I mentioned (Sphincter of Oddi), in the duodenum, that triggers a hormone called cholecystokinin (CCK) and this hormone causes the smooth muscles round the gallbladder to contract and squeeze. If the CBD is blocked (by a stone or other blockage) the pressure builds up and causes that really dreadful colicky pain. Protein also triggers CCK to an extent but fat is the main culprit. I felt no real desire to eat anything much and certainly not fat. Aim for zero fat if she can, which isn't possible of course and anyway we need some fat and calories. Just go ultra low fat.
There is a drug available in pharmacies called Buscopan which is sold for IBS. Buscopan reduces spasm in abdominal smooth muscle and can greatly reduce spasm in the gallbladder. I was given it i/v in hospital and my GP prescribed the tablets for me. It helps. You can buy from the chemist but remember that the chemist isn't supposed to sell you a medicine for anything not on the label. What's on the label is IBS. So might be best not to talk about gallstones....?
My pain was very severe and I was given oral morphine to take at home. That helps enormously though my consultant wasn't too keen; he didn't like the idea of covering up such a severe pain and said it's better to go to A&E if in terrible pain. My consultant probably has little experience of being a customer in A&E!! Maybe your sister can discuss with her GP.
What doesn't seem to work at all is Gaviscon or other indigestion remedies such as Zantac. When you think about it you wouldn't expect them to work!
Thanks for that, will pass all info on...
You're welcome. Gallstones are renouned for their horrible-ness. Your sister can expect a huge amount of support and understanding. In one of my trips to A&E at 0300 a doctor in her early 30s said she'd suffered in the past. Last week there was a girl waiting with me for the same op and same endoscopist who was barely 20. We seem to be getting them earlier and earlier; I suppose it's all about our diet?
I`m not sure about that, I said to my sister I wonder why some people get them and not others. She has always been, as long as I can remember, a vegetarian (she`s 50) with low (4) cholesterol.....she didn`t even know she had them till she was violently ill through medication (sick) and intense pain followed...we can only assume she disturbed them!...She is awaiting a steroid for her Arthritis...she seems to have pain everywhere, which is difficult to deal with....but at least the stone problem can be resolved, and hopefully life for her will ease!
I presume (hope) that they have visualised (ultrasound and MRI) the stone(s) in the GB and the CBD? Inflammation of the pancreas can produce identical pain and jaundice even if there are no stones at all. Some medication can cause the pancreas to play up.
Yes, she had xrays and MRI (with fluid) a couple of weeks ago. She got the letter this week to say ,they are doing endoscopy to remove stones in bile duct area...and full gallbladder removal, where she has stones as well, at a later date...she has just had phone call to give her the date for endoscopy.....Afternoon appointment, possibly returning home same day...
I was told also to take Buscopan by my doctor and it worked wonders for 4 months until I had my Gallbladder on Monday. Now don't need any tablets at all. Just waiting now to see if I have any other symptoms to deal with.
It seems a mixed bag as to weather there are any after effects when gallbladder is removed, to deal with, but I tell my sister that a lot of the people on here are asking questions about problems (or like me, asking about operations to come...... Tom seems to be doing well, and yourself...hope you continue to keep well! It`s reassuring for my sister who is very nervous about having anything done...
Hi Linda ,
i had both of these procedures . My advice would be :- after the ERCP do not eat any fat whatsoever and try to push to have the gall bladder removed asap . I wrongly thought after the ERCP that as they had done a syhincterotmy at the same time , that this meant any future stones would just flow out . The fat in your diet makes the gall bladder move , which makes the stones move , which can still get stuck in your cystic duct Or the bile duct or in my case both , which can then lead to a whole host of problems .
i was most worried about the ERCP , but really both procedures were fine , it was in between the 2 procedures that I had the most problems . But I'm sure that I was atypical and that after you have had the ERCP you will be fine until your operation .
Hi heepee, I have had continuous loss of appetite, mild nausea and constipation since the ERCP (with sphyncterotomy) and waiting to see if I am going forward to removal of the GB. My stools are very dark chocolate brown (not melaena just dark) which is all very uncharacteristic for me. Did you enjoy the same after your ERCP? I am one week in. Thanks.
Thank you for that......
Thank you for that.....
No I didn't really have those , but my stools never went light unlike many . After your ERCP your stones do pass out in your stools, so maybe that's why they are darker ? My consultant told me that after you've had gall stones , you will always get another attack of biliary colic , maybe not for months or years but you will always get them . Given this I wanted to have my gb out , but thought no real rush . This was wrong ( for me ) . given that you are only a week after your ERCP I wouldn't worry too much , unless you are in pain and then if the pain is bad go straight to your gp or A&E . Best of luck .
Thank you for that. I had jaundice and light stools and was in hospital with morphine for the pain. Proper poorly. I don't think the darkness is due to passing stones but I suspect there'll be a lot of bile coming down and the Sphyncter of Oddi is probably not sealing, dribbling bile down into the duodenum. I wonder if that is constipating. I am seeing the consultant in a few weeks so won't do anything for now.
Very reassuring to hear that you are fine. Infection into the pancreas seems to be their biggest worry.
It`s inetresting reading all these things that can occur after stone removal....at least I can tell my sister, if these things happen, why they have...We are all different of course. Hope you all comtinue to improve....
Just one thing to bear in mind: If we've had an immediate 'cure' from any medical intervention we tend to just get on with our lives not tune into Internet forums so I imagine those here (including myself) are amoung the least fortunate. Hopefully your sister will have a smooth ride. Let us know how she gets on.
Yes, I agree, I have told her this...people on here, are after answers and/or reassurance....she has her Endoscopy 3rd August...will keep you posted, it`s interesting to compare...especially hospitals!! Thank You...