ERCP is a procedure that uses an endoscope and X-rays to look at the bile duct and the pancreatic duct. ERCP can also be used to remove gallstones or take small samples of tissue for analysis or to insert stents in case of obstruction.

The endoscope is passed through the mouth down into the first part of the small intestine/ duodenum. A dye is injected into the bile and pancreatic ducts, through an opening in the duodenum known as the papilla, so that these ducts show up clearly on X-ray pictures.

The patient should be fasting for at least 6 hours prior to the procedure. A local anesthetic is sprayed in the patient’s throat prior to the administration of an intravenous medication for sedation. The procedure can take anything from 30 minutes to over an hour, depending on what is done.

Occasionally the endoscope can cause some damage to the gut, bile duct or pancreatic duct. This may cause bleeding, infection and, rarely, perforation. Inflammation of the pancreas (pancreatitis) sometimes occurs after ERCP and can be serious in some cases.