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ERCP

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. Through the GastroDoxs GutDefense Pathway™, patients receive clear guidance from diagnostic evaluation to treatment planning and follow-up care.

Dr. Bharat Pothuri Medically Reviewed by Dr. Bharat Pothuri, MD, FACG  |  Updated 03-24-2026
What to Expect Download Free Guide
Bile ducts Pancreatic ducts Therapeutic procedure Board-Certified Gastroenterologist

What Is ERCP?

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.

Understanding ERCP

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.

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GastroDoxs GutGuardians™

Your guardians. GastroDoxs GutGuardians™ is an elite team of board-certified gastroenterologists - a physician-led defense force of specialists, systems, and solution pathways working together to protect, detect, solve, and defend your digestive health through expert GI evaluation, advanced diagnostic screening, and endoscopic evaluation - commanded from your first concern to your last follow-up, and every critical stage in between.

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GastroDoxs GutDefense Pathway™

Your complete arc. The GastroDoxs GutDefense Pathway™ is your complete operational framework - a structured patient journey that connects digestive health awareness, education, screening, prevention, diagnosis, and treatment into one seamless board-certified gastroenterologist-commanded arc, guided by expert GI care from your first concern to lasting gut health for life.

Why Is ERCP Done?

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.

Bile duct stones

Bile duct strictures

Pancreatic duct problems

Stent placement

Jaundice

Abnormal liver tests

How Gastroenterologists Decide on ERCP

The decision to recommend ERCP is based on symptoms, medical history, exam findings, lab results, imaging, prior testing, medication response, and the goal of the evaluation. This helps ensure the procedure or test is clinically appropriate and connected to a clear next step.

What Can ERCP Help Evaluate?

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.

Bile duct stones

Bile duct strictures

Pancreatic duct problems

Stent placement

Jaundice

Abnormal liver tests

How Results Are Interpreted

Results from ERCP are reviewed in context with your symptoms, risk factors, prior testing, and clinical history. Your gastroenterologist explains whether results suggest monitoring, treatment, additional testing, or follow-up care.

ERCP Alternatives and Related Testing

ERCP may be one part of a broader digestive health evaluation. Depending on the concern, alternatives or related tests may include blood work, stool testing, imaging, endoscopy, ultrasound-based testing, or follow-up monitoring. Your gastroenterologist helps choose the most appropriate option.

Who May Need ERCP?

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.

Patients with Bile duct stones

Patients with Bile duct strictures

Patients with Pancreatic duct problems

Patients with Stent placement

Patients with Jaundice

Patients with Abnormal liver tests

Is ERCP Always the First Test?

Not always. A gastroenterologist considers symptoms, prior testing, risk factors, and treatment goals before deciding whether ERCP is the right next step.

Patient Journey: Before an ERCP, Most Patients Feel the Same Way

It usually isn’t fear of the procedure itself. It’s uncertainty — about why it is needed, what bile duct or pancreatic duct problems may be found, and how treatment might be performed during the same procedure. Many people delay simply because symptoms like pain or abnormal labs feel unclear or intermittent.

But once ERCP is clearly explained, it becomes more structured — a targeted procedure used to diagnose and treat bile duct and pancreatic duct conditions in a controlled, therapeutic setting.

Read the ERCP Experience →

Benefits of ERCP

ERCP can provide useful information about digestive or liver health and may help your gastroenterologist plan the next step.

Helps evaluate bile duct stones

Helps evaluate bile duct strictures

Helps evaluate pancreatic duct problems

Helps evaluate stent placement

Helps evaluate jaundice

Helps evaluate abnormal liver tests

Are There Risks with ERCP?

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.

When Should You Talk to a GI Specialist?

Talk to a gastroenterologist if symptoms persist, results are unclear, or your doctor recommends ERCP for diagnosis, monitoring, or treatment planning.

Related ERCP Guides

Use these next-step pages when you are ready to understand preparation, scheduling, or related digestive health topics.

What to Expect

Learn preparation, procedure-day expectations, recovery, and how results may be discussed.

Schedule ERCP

Review appointment, location, insurance, and scheduling details.

Bile duct stones

Learn how bile duct stones may relate to digestive or liver evaluation.

Bile duct strictures

Learn how bile duct strictures may relate to digestive or liver evaluation.

Pancreatic duct problems

Learn how pancreatic duct problems may relate to digestive or liver evaluation.

Stent placement

Learn how stent placement may relate to digestive or liver evaluation.

ERCP Prep Overview

Quick Answer: What should adults know about ERCP prep?

ERCP preparation depends on the reason for the test, the setting, and your health history.

Follow the written instructions from your GastroDoxs care team, including medication guidance, arrival time, and transportation planning when sedation is used.

ERCP Video Instructions

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.

Where to Learn the Next Step

Want procedure-day details?Review the full guide for preparation, procedure-day expectations, recovery, and how results are discussed. Learn more
Ready to discuss scheduling?If ERCP may be appropriate, use the scheduling page to understand appointment options. Learn more

Frequently Asked Questions

Answers are reviewed for clinical accuracy based on standard gastroenterology practice guidelines.

What is endoscopic retrograde cholangiopancreatography used for?

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.

What are the techniques used in endoscopic retrograde cholangiopancreatography?

Techniques include contrast injection for imaging, sphincterotomy, stent placement, balloon dilation, and stone removal, all performed using an endoscope and X-ray guidance.

How do you prepare for endoscopic retrograde cholangiopancreatography?

Fast before the procedure, stop certain medications if advised, arrange for someone to drive you home, and follow your doctor’s pre-procedure instructions.

What are the complications of endoscopic retrograde cholangiopancreatography?

Possible complications include pancreatitis, infection, bleeding, perforation, allergic reaction to contrast dye, and anesthesia-related side effects. These risks are rare but serious.

What is another name for ERCP?

ERCP is also called Endoscopic Cholangiopancreatography because it visualizes and treats bile and pancreatic ducts using an endoscope and contrast-enhanced imaging.

Need an ERCP Evaluation?

Schedule with GastroDoxs to review your symptoms, imaging, lab results, and whether ERCP is the right next step.

Learn What to Expect See Scheduling Options