What is ERCP?
ERCP (Endoscopic Retrograde Cholangiopancreatography) is a specialised procedure that combines endoscopy with X-ray imaging to diagnose and treat conditions affecting the bile ducts, gallbladder, pancreatic duct, and associated structures.
Using a side-viewing endoscope, the specialist accesses the bile and pancreatic ducts through a small opening in the duodenum (the major duodenal papilla), allowing for both diagnostic assessment and therapeutic interventions in the same procedure.
When is ERCP Used?
- Bile duct stones (choledocholithiasis)
- Bile duct strictures or narrowing
- Obstructive jaundice investigation and treatment
- Pancreatic duct disorders and strictures
- Biliary stenting for malignant obstruction
- Sphincter of Oddi dysfunction
- Post-surgical biliary complications (e.g. bile leak)
- Primary sclerosing cholangitis (PSC) management
- Ampullary disorders
What Happens During ERCP?
Preparation & Sedation
You fast beforehand. Deep sedation or general anaesthesia is typically used for this procedure given its complexity and duration.
Endoscope Insertion
A side-viewing endoscope is gently passed through the mouth into the duodenum to access the bile duct opening.
Contrast Injection & Imaging
Contrast dye is injected into the ducts and X-ray imaging (fluoroscopy) is used to visualise the bile and pancreatic ducts.
Therapeutic Intervention
Interventions such as stone removal (sphincterotomy), stent placement, or balloon dilation are performed as clinically indicated.
Recovery
You recover in a supervised area. ERCP requires a responsible adult to drive you home. Observation may be required before discharge.
Important Information Before Your ERCP
- Fasting is required for at least 6–8 hours before the procedure
- Inform your doctor about all medications, especially blood thinners and diabetes medications
- Blood thinners may need to be paused before the procedure
- You will require a responsible adult to drive you home
- Hospital admission may occasionally be required after complex ERCP
After the Procedure
Most patients are observed in recovery for 1–2 hours and can go home the same day. Some patients may require overnight admission. Mild abdominal discomfort is common. Your specialist will discuss results and next steps with you. The most important potential complication is pancreatitis, which occurs in a small percentage of cases; our team will explain all risks prior to the procedure.