Endoscopic retrograde cholangiopancreatography is abbreviated as ERCP. It is a bile duct examination method. It is performed using an endoscope.

  • The tubes that transport bile from the liver to the gallbladder and small intestine are known as bile ducts.
  • ERCP is used to treat and assess bile duct stones, tumors, and constricted regions.


Your arm is pierced with an intravenous (IV) line. For the test, you will lie on your stomach or on your left side.

  • You will be given medications to calm or sedate you via IV.
  • A throat numbing spray is sometimes utilised as well. To protect your teeth, a mouth guard will be placed in your mouth. Dentures must be taken out.

The endoscope is placed into the mouth once the sedative has taken effect. It travels via the esophagus and stomach until it reaches the duodenum (the section of the small intestine nearest to the stomach).

  • You should not be bothered by the test, and you may have little recollection of it.
  • As the tube is passed down your esophagus, you may gag.
  • As the scope is inserted, the ducts may be stretched.

A tiny tube (catheter) is introduced via the endoscope and placed into the pancreatic and gallbladder ducts. An x-ray is obtained after a specific dye is injected into these channels. This allows the doctor to see stones, tumors, and any constricted regions.


Special instruments can be inserted into the ducts via the endoscope.

Why the Procedure is Performed

The procedure is used mostly to treat or diagnose problems of the pancreas or bile ducts that can cause abdominal pain (most often in the right upper or middle stomach area) and yellowing of the skin and eyes (jaundice).

ERCP may be used to:

  • Open the entry of the ducts into the bowel (sphincterotomy)
  • Stretch out narrow segments (bile duct strictures)
  • Remove or crush gallstones
  • Diagnose conditions such as primary biliary cholangitis or sclerosing cholangitis
  • Take tissue samples to diagnose a tumor of the pancreas, bile ducts, or gallbladder
  • Drain blocked areas

Note: Imaging tests generally will be done to diagnose the cause of symptoms before an ERCP is done. These include ultrasound tests, CT scan, or MRI scan.


Risks of the procedure include:

  • Reaction to the anesthesia, dye, or drug used during the procedure
  • Bleeding
  • Hole (perforation) of the bowel
  • Inflammation of the pancreas (pancreatitis), which can be very serious

Before the Procedure

  • You will need to not eat or drink for at least 4 hours before the test. You will sign a consent form.
  • Remove all jewelry so that it will not interfere with the x-ray.
  • Tell your health care provider if you have allergies to iodine or you have had reactions to other dyes used to take x-rays.
  • You will need to arrange a ride home after the procedure.

After the Procedure

  • Someone will need to drive you home from the hospital.
  • The air that is used to inflate the stomach and bowel during an ERCP can cause some bloating or gas for about 24 hours. After the procedure, you may have a sore throat for the first day. Soreness may last for up to 3 to 4 days.
  • Do only light activity on the first day after the procedure. Avoid heavy lifting for the first 48 hours.
  • You can treat pain with acetaminophen (Tylenol). DO NOT take aspirin, ibuprofen, or naproxen. Putting a heating pad on your belly may relieve pain and bloating.
  • The provider will tell you what to eat. Most often, you will want to drink fluids and eat only a light meal on the day after the procedure.

Seek medical help immediately, if:

  • Abdominal pain or severe bloating
  • Bleeding from the rectum or black stools
  • Fever above 100°F (37.8°C)
  • Nausea or vomiting
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