Endoscopic Retrograde Cholangiopancreatography (ERCP)


Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure that allows a doctor see the bile and pancreatic ducts to check for and treat problems. ERCP is a combination of upper GI (gastrointestinal) endoscopy and X-ray imaging. Upper GI endoscopy involves having a flexible tube (endoscope) inserted into the mouth to view the upper part of the GI system, which includes the esophagus, stomach and first part of the small intestine (duodenum). The endoscope has a camera in it and pictures are projected onto monitors.
ERCP can be used to remove tissue samples for a biopsy, open a blockage in a bile or pancreatic duct caused by a tumor, gallstones, or other causes, or to place a piece of plastic or metal (a stent) into a duct to help keep open an area that was blocked. If gallstones are found during ERCP, they can be removed right then.

What to Expect

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.


After the procedure, you’ll rest in a recovery room, and you’ll need someone to drive you home. Your throat might hurt slightly for a day or two after ERCP.

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