Endoscopic ultrasound

An endoscopic ultrasound uses an endoscope and an ultrasound scanner. It is much the same as having an endoscopy. But an ultrasound probe is attached to the endoscope tube.

This test can help doctors to work out the stage of cancer. It also helps to show if the cancer has grown into the wall of the gallbladder or spread to the liver. This helps to plan for surgery.

Preparing for your test

You might have a blood test 2 days beforehand to check how well your blood clots.

Tell your doctor if you're having medicine that changes how your blood clots. This includes:

  • aspirin
  • clopidogrel
  • arthritis medicines
  • warfarin or heparin
  • apixaban or rivaroxaban

Your doctor tells you if you need to stop taking any other medicines.

You can't eat for 6 to 8 hours before the test but you might be able to drink sips of water up to 2 hours before your appointment. Your doctor or nurse gives you written instructions about this beforehand.

Talk to your doctor if not eating could be a problem for you. For example, if you have diabetes.

Your doctor will explain what they are going to do and you’ll sign a consent form. This is a good time to ask any questions you might have.

How you have it

Usually you have an endoscopy in hospital as an outpatient. A doctor or a specialist nurse (endoscopist) does the test. A nurse stays with you when you have it. The test usually takes less than 30 minutes.

When you arrive at the clinic, the staff might ask you to take your upper clothing off and put on a hospital gown. 

You might have the test while you're awake but you can choose to have a medicine to make you drowsy (a sedative).

What happens

You lie down on the couch and have an injection of the sedative. It takes a few minutes for you to become sleepy.

Then the endoscopist passes the endoscope down your throat into your food pipe. The tube has an ultrasound probe. This uses sound waves to build up a picture so your doctor can see the food pipe, stomach and surrounding areas. They might also be able to see if the nearby lymph nodes are swollen (enlarged).

Diagram of an endoscopy

The endoscopist gently removes the tube.

After your endoscopy

You need to rest for a while after the test.

You can't eat or drink for about an hour, until the local anaesthetic throat spray wears off. You might not remember much about the test if you have had a sedative drug.

You should be able to go home the same day. You can't drive or drink alcohol for 24 hours after having a sedative. You need someone to take you home from hospital and stay with you during this time.

Getting your results

You should get your results within 1 or 2 weeks at a follow up appointment. 

Waiting for test results can be a very worrying time. You might have contact details for a specialist nurse who you can contact for information if you need to. It can help to talk to a close friend or relative about how you feel.

You can also contact the Cancer Research UK nurses on freephone 0808 800 4040 for information and support. The lines are open from 9am to 5pm, Monday to Friday.

Contact the doctor who arranged the test if you haven’t heard anything after a couple of weeks.

Possible risks

An endoscopy is a very safe procedure. But your nurse tells you who to contact if you have any problems afterwards. Your doctors make sure the benefits of having an endoscopy outweigh the possible risks.

The possible risks include:

A sore throat

You might have a sore throat for up to 24 hours. Contact the hospital if you have severe pain in your throat, chest or tummy (abdomen).

Bloating

You might have bloating or mild discomfort for several hours after the test. This is due to the air that the endoscopist puts into the stomach during the test.

Bleeding

There is a risk of bleeding from the biopsy site. This is usually a small amount and stops on its own. In rare cases you may need to have a blood transfusion.

Small tear

There is a risk of a small tear (perforation) in the food pipe, stomach or small bowel. This is rare but can be serious. 

Fluid going into your lungs

There is a very small risk of fluid going into your lungs from your mouth during the test. Your nurse uses a tube to remove most of the fluid from your mouth to reduce this risk.

Shortness of breath

A reaction to the sedative can cause breathing difficulties but this is rare. Your nurse checks your oxygen levels during the test. You have oxygen through a tube that fits into your nose (nasal cannula).

Last reviewed: 
09 Jan 2020
  • The Royal Marsden Manual of Clinical Nursing Procedures, 9th, Professional Edition
    L Dougherty and S Lister (Editors)
    Royal Marsden Manual Series, Wiley-Blackwell, 2015

  • Biliary cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow up
    Valle J W and others (2016)
    Annals of Oncology 27 (supplement 5): v28-v37

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