Endoscopic retrograde cholangiopancreatography, or ERCP, is a specialized procedure that helps diagnose and treat bile duct and pancreatic duct problems such as stones, strictures, blockages, and selected post-surgery complications.
Medically Reviewed by Dr. Bharat Pothuri, MD, FACG | Updated 03-24-2026
ERCP combines endoscopy and X-ray guidance to examine the bile ducts and pancreatic ducts. A contrast agent may be injected through a catheter so the ducts can be seen clearly.
Unlike many diagnostic tests, ERCP can also treat certain problems during the same procedure.
ERCP may be used to find stones, tumors, narrowing, leaks, or blockages. It may also remove stones, open narrowed ducts, or place a stent when clinically appropriate.
ERCP may be recommended when symptoms, labs, imaging, or surgical history suggest a bile duct or pancreatic duct problem.
ERCP can help remove gallstones that have moved into the bile duct.
Narrowed or blocked ducts may be evaluated and treated with dilation or stent placement.
ERCP may be considered after imaging or lab results suggest a duct issue.
ERCP can help diagnose and treat selected problems after gallbladder surgery.
ERCP can help evaluate cancerous or non-cancerous lesions involving the ducts.
The procedure may help restore flow when drainage is blocked.
ERCP can be diagnostic and therapeutic, which means your doctor may identify the problem and treat it during the same procedure.
Gallstones may be removed from the bile duct and, in selected cases, from the pancreatic duct area.
A small plastic or metal stent may be placed to help open a blocked duct.
The duct opening or narrowed areas may be treated using specialized ERCP tools.
When needed, tissue samples may be taken to help guide diagnosis and treatment.
Your GI specialist may recommend ERCP after reviewing symptoms, medical history, labs, imaging, and whether treatment may be needed during the procedure.
Yellowing of the skin or eyes, dark urine, pale stools, pain, or abnormal labs may need further evaluation.
Some patients need ERCP when symptoms or imaging suggest a retained stone, leak, or narrowing.
MRCP, CT, ultrasound, or other imaging may show duct dilation, stones, or obstruction.
Possible complications include pancreatitis, infection, bleeding, perforation, allergic reaction to contrast dye, and anesthesia-related side effects. These risks are uncommon but important to discuss with your care team.
Follow your GastroDoxs and surgery center instructions carefully. Preparation may include fasting, medication review, clearance, transportation planning, and pre-assessment registration.
Do not plan to drive after your procedure. You must have someone 18 years old or older drive you home. No Uber, Lyft, or cab.
Tell your care team about blood thinners, diabetes medicines, GLP-1 medications, allergies, and major health conditions.
Follow fasting instructions from your care team. The original guide notes no food or liquids on procedure day unless instructed otherwise.
Watch this overview in the bottom half of the page, then follow the written instructions from your GastroDoxs care team for your exact prep timing, medication guidance, arrival time, and transportation plan.
| Want procedure-day details? | Review the full guide for preparation, sedation, what happens during ERCP, recovery expectations, and how findings and treatment options are discussed. Read what to expect during ERCP. |
| Ready to discuss ERCP? | If you have been referred for ERCP or need evaluation for bile duct, pancreatic duct, or gallstone-related conditions, review appointment and consultation options. See ERCP scheduling options. |
ERCP is used to diagnose and treat bile duct and pancreatic disorders, such as gallstones, strictures, tumors, pancreatitis, and bile duct obstructions by combining endoscopy and fluoroscopy.
Techniques include contrast injection for imaging, sphincterotomy, stent placement, balloon dilation, and stone removal, all performed using an endoscope and X-ray guidance.
Fast before the procedure, stop certain medications if advised, arrange for someone to drive you home, and follow your doctor’s pre-procedure instructions.
Possible complications include pancreatitis, infection, bleeding, perforation, allergic reaction to contrast dye, and anesthesia-related side effects. These risks are rare but serious.
ERCP is also called Endoscopic Cholangiopancreatography because it visualizes and treats bile and pancreatic ducts using an endoscope and contrast-enhanced imaging.