failed ERCP

I spent three hrs in surgery yesterday with full anesthesia, a breathing tube and a scope down my throat. They were trying to do an ERCP on me with a longer scope, but they couldnt get it. I am miserable this morning, sore throat, with awful drainage, like a really nasty sinus infection backing up down my throat. even my stomach is sore. I wouldnt have thought you could feel any of the scope placements? I am disappointed that they couldnt get to the stone in my common bile duct. Now we try the riskier "put a new hole in your old stomach" routine, while also removing the gallbladder. ERCPs usually take less than an hour, mine took a LOT longer than they had me even scheduled for (2 hrs) I am wondering if this kind of internal bruising feeling is normal? and any suggestions for my draining throat? Also, anyone out there have to have the hole put in their old stomach, and what are the risks?

Ps the Doc told my dh that he "tattooed" me where he left off. wth is that all about?

Sometimes docs will leave a marker at a specific site so that future imaging will immediately show the site. I had breast surgery, on one side, and it looks like Frankenboob in the Mammograms.

As to the ERCP... I was surprised they were even going to attempt it. going in through the esophagus, through the pouch, down to the Y junction, and up back to teh stomach area..... that would take a LOONG tool, and be quite convoluted. I was told that ERCP (for my sphincter of oddi issues) is prettty much contraindicated in an RNY patient. Sounds like in attempting to maneuver the tool down one thing and up another, the inevitable moving around of the tool in your esophagus bruised stuff up, which would probably result in increased mucous formation and that sick-throat sensation you described.

When you say a hole through your old stomach, he's going to go in laproscopically through your stomach wall, then down to the bile duct (a short journey, relatively)? That sounds about like what was described to me if I wanted to get to the bottom of GB-like symptoms. If my symptoms don't go away on their own any of these times, that's what the docs will have to do to find out what is going on.

Since you already know you have a stone in the duct (?) then there isn't much else to be done. If it was just exploratory, to see if you do, there's something called the MRCP... an MRI scan that can do a lot or all (not sure) of what an ERCP can do but that is less risky overall.

thanks for your reply. I had the MRCP a few weeks ago, that determined I have several stones in the common bile duct.(And a loaded GB to boot) They put me on actigall to try to slow down production. No one mentioned till yesterday that the odds of the surgery working were only 30%! My doc conferred with a gastro doc who ordered a longer scope, and he thought he had a decent shot at it. Usually, ercp is a procedure, not a surgery, but mine was a surgery I guess because of the type of anesthesia and length of time being under.
Ide like to take mucinex or something for this mucous, but not sure it would help where it isnt caused by a cold. My innards feel very bried up, which I guess makes sense given three hours of prodding and pushing. I guess it surprises me because i figured theres no nerve endings there.
My doc drew a diagram of the three steps to try to get the stones. The ERCP was first, then the second option is the incision through my old stomach to use a shorter route to get to the stone, which risks a leak...yuck. Third option is an open surgery to get the stone, take the gb out, and tie my tubes while theyre in there lol. I had trouble back in auguest (bypass was in may) and ended up in surgery number two then, with the same symptoms, but they didnt see any stones then on hida scan. so doc fixed some adhesions and a hernia and sewed me up. I KNEw the actigall was helping then, and told them so. But she said where I didnt have stones that didnt make sense. I guess the moral is..trust your body. So surgery number three didnt work, and I will have number four pretty quick now. Trying to keep positive, but Ide really like this to be over soon.

I have been referred to a specialist to have an ERCP after RNY.  My doctor drew the pictures and told me that the specialist has been doing these on RNY patients for a long time.  He explained that he may not be able to get to the area he needs to but this doctor is my best shot.  If he cannot get the scope where it needs to be then I will have to have an open procedure - by open, I do mean open because I have serious scar tissue and some  other wonderful leftovers from when my bypass came apart internally and I became septic.    I would like to hear from anyone who has had a successful ERCP after gastric bypass.

I, too, am surprised that they tried doing it that way.  When I had pancreatitis and had to have my gallbladder out, the surgeon warned me that he might run into a problem with a stone in the common duct (and I had to sign an authorization for him to do the additional procedure if it was necessary, since it would mean more than just the lap surgery), but he indicated that there was only one reliable way to deal with that and that most other attempts are unsuccessful (and that he didn't want to have to subject me to a second surgery).

I am so sorry you now have to go through the additional procedure.

Lora

My wife had a braiatric-assisted ERCP in December 2012.  We hope it worked--they cut openings in the bile and pancreas ducts.  However, she got really bad pancreatitis and was in the hospital for 17 days.   Now she might have an ulcer from the stress of the pancreatitis.  Ugh.  However, she hasn't had pancreatitis since.   

 

 

Babygirl, I know the frustration you must be feeling and the desparation because of the PAIN!!! I had gallbladder related problems before and after RNY.  My ERCP was done before RNY and they removed 'a stone' out of my CBD.  The painful attacks subsided....wonderful.  But remember, rapid/large weight loss causes an increased production of bile and so when I lost 75lbs or so in 5 or 6 months I started to have that miserable gallbladder-attack-like pain in the upper right quad like never before.  Every couple of days or every day two and three times a day w/ vomiting and nausea (pancreatitis?).  So, they could have split me in two to remove it....I would have signed on the dotted line.

But that wasn't necessary.  Luckily and firstly, I had done a lot of research and I KNEW exactly what was going on with my body from the start....I had my gallbladder removed long ago and I had already diagnosed myself with either SOD or having another stone before RNY.  But, nevertheless, my surgeon(s) were VERY VERY GOOD!  RNY surgeon went in as an expert and led the scope through my NEW AND REARRANGED digestive system, lapriscopically.  Then the GI surgeon (same guy who did the ERCP) went in and 'found my stone'.  My stone was way up high in the CBD branches and he found that to be particularly interesting and could have posed to be challenging but he was EXCELLENT.  They actually used some of the previous insertion areas that were used for the RNY.  One of the areas was very sore because the scope was larger.  So, this was a surgery and not a procedure.  For them to do an ERCP on you after RNY is technically an impossibility!!!  They can't do an ERCP on a RNY patient. 

I believe that they did have to enter in through my remnant, but I'm not clear on that fact right now.  They might have.