ERCP takes place at a hospital, surgery center or clinic. Beforehand, you’ll be asked to fast for about 8 hours and to avoid smoking and taking certain medications. Once at the hospital, your throat will be numbed with a local anesthetic and you may also have a sedative through a needle in your arm (IV or intravenous). Then a flexible tube (endoscope) is inserted through your esophagus to your stomach, duodenum and bile/pancreatic duct. The tube has a tiny camera that transmits pictures to a monitor.
Your doctor will place air or CO2 into your stomach and small intestine through the endoscope, which helps provide better pictures. A thin tube (catheter) will be placed through the endoscope to inject dye to make the ducts more visible on X-rays. Tools inserted through the endoscope can be used to remove cells for testing, open blockages, remove or break up stones, remove tumors or insert stents.