Published with the inputs from Dr Biju I K, Chief & Senior Consultant,  Medical Gastroenterology And GI Endoscopy, Baby Memorial Hospitals- Kozhikode

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a procedure that combines endoscopy and X-ray imaging to diagnose and treat problems in the bile ducts, gallbladder, and pancreas. It is commonly used to remove gallstones, open blocked ducts, place stents, or take tissue samples for diagnosis.

What is ERCP, and why is it done?

ERCP is performed to diagnose and treat conditions affecting the bile ducts and pancreas. It is commonly used for gallstones, bile duct narrowing (strictures), blockages, tumors, and chronic pancreatitis.

How is ERCP performed?

During ERCP, a flexible tube with a camera (endoscope) is passed through the mouth into the stomach and small intestine. A special dye is injected into the bile and pancreatic ducts, and X-ray images are taken. If needed, the doctor can:

• Remove bile duct stones
• Removal of pancreatic stone
• Open blocked bile duct and pancreatic ducts
• Insert stents to keep ducts open
• Collect tissue samples (biopsy)
• To correct the leakage

Is ERCP painful?

No. ERCP is done under sedation or anesthesia, so patients do not feel pain during the procedure. Some mild throat discomfort or bloating may occur afterward, but usually resolves quickly.

What are the risks of ERCP?

ERCP is generally safe, but possible risks include:

• Pancreatitis (inflammation of the pancreas)
• Infection in the bile ducts (Cholangitis )
• Bleeding
• Perforation of the digestive tract

These risks are uncommon and are minimized when the procedure is performed by experienced specialists.

What is recovery like after ERCP?

Most patients go home the same day or after an overnight stay. Light food and drinks are usually resumed once sedation wears off. Some may feel bloating, nausea, or mild abdominal discomfort. Patients should avoid driving or strenuous activity for 24 hours.

How long does ERCP take?

The procedure usually takes 30–90 minutes, depending on whether only imaging is done or treatment (like stone removal or stenting) is also performed.

What are the alternatives to ERCP?

In some cases, non-invasive imaging tests like MRCP (Magnetic Resonance Cholangiopancreatography) or Endoscopic Ultrasound (EUS) may be used for diagnosis. However, unlike ERCP, these tests cannot treat the problem at the same time.

Nowadays ERCP is done only in cases where therapeutic work is anticipated. So no diagnostic procedure can replace a therapeutic ERCP. The only alternative will be surgery, which is  more invasive and expensive. 

Connect with Our Experts Today

If you have been diagnosed with gallstones, bile duct blockage, or pancreatitis, our Gastroenterology & GI Endoscopy Team at Baby Memorial Hospitals provides advanced ERCP procedures for both diagnosis and treatment.

📞 Call us or book an Appointment Online to consult with our specialists.