ERCP is a specialized procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions affecting the bile ducts, gallbladder, pancreas, and liver. It involves the use of a flexible endoscope that passes through the mouth into the stomach and the first part of the small intestine (duodenum), allowing the physician to inject a contrast dye into the bile and pancreatic ducts to visualize them on X-ray.
ERCP is commonly performed to identify and treat conditions such as:
Gallstones blocking the bile duct
Infections or inflammation in the bile ducts (cholangitis)
Narrowing (strictures) or obstruction of the bile or pancreatic ducts
Leaks from trauma or surgery
Pancreatic duct issues or chronic pancreatitis
Tumors in the bile duct or pancreas
It allows both diagnosis and treatment in a single session — for example, stones can be removed, stents can be placed to relieve obstructions, and tissue samples (biopsies) can be taken if needed.
Preparation
You will need to fast for several hours before the procedure to ensure your stomach is empty. Inform your doctor about all medications, allergies, and existing health conditions, especially if you take blood thinners or have heart problems. Sedation is typically administered to help you relax and minimize discomfort.
During the Procedure
The doctor inserts a thin, flexible tube (endoscope) through your mouth and guides it down to the duodenum. A small catheter is then passed through the scope into the bile or pancreatic ducts, where contrast dye is injected for X-ray imaging. Depending on the findings, therapeutic actions such as stone removal, stent placement, or dilation of narrowed ducts may be performed.
After the Procedure
You’ll be monitored until the sedative wears off. Mild throat discomfort or bloating is normal for a few hours. Your physician will review the results and provide instructions for diet and medications. Avoid driving or operating machinery for the rest of the day due to sedation effects.
While ERCP is generally safe, potential risks include pancreatitis (inflammation of the pancreas), infection, bleeding, and perforation of the intestine or bile ducts. These are rare and are minimized by experienced specialists using advanced equipment and sterile techniques.
