Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure that assists with the diagnosis and treatment of problems of the liver, gallbladder, bile ducts and pancreas. ERCP combines X-rays and endoscopy which involves the use of a long, thin, flexible tube with a video camera and light on the end to carefully navigate the inside of the upper gastrointestinal system.

ERCP is usually indicated to diagnose and treat conditions of the bile or pancreatic duct which include blockage or narrowing due to gallstones, tumours, infection, scarring, accumulation of tissue debris and fluid or inflammation of the pancreas. ERCP is also used to obtain brushings or a biopsy to help with the diagnosis of certain conditions.

ERCP is usually performed as a Day-only procedure. You are placed on an X-ray table, on your back or side. While asleep, the ERCP scope is inserted into your mouth, down into the stomach and then into the upper part of the small intestine (duodenum). Once the endoscope reaches the papilla - the place where the pancreas and bile ducts meet - a thin wire is inserted into it through a tube (catheter). Dye is then injected into the ducts. X-ray images are taken to diagnose any problem related to the ducts. When a problem is detected, your doctor may be able to treat your condition immediately. This may include a sphincterotomy (cutting of the small muscle at the entrance of the duct with a wire) to assist with drainage of bile from the duct. Sometimes a small tube called a stent that can be plastic or metal may need to be left in the duct to help the bile flow into the bowel.