Endoscopic Retrograde Cholangiopancreatography (ERCP)

What is Endoscopic Retrograde Cholangiopancreatography (ERCP)? Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic and treatment tool used in diseases of the pancreatic duct, bile ducts, and gallbladder.

ERCP is performed by passing an endoscope through the oral cavity to the level of the duodenum where other tools can be advanced to inject contrast dye for visualization, for diagnostic procedures, such as biopsies and brush cytology, or for therapeutic procedures.

When is ERCP Used?

Some indications for ERCP include:

  • Choledocholithiasis
  • Suspicion of pancreatic cancer
  • Biliary or pancreatic ductal system disease treatment or tissue sampling
  • Pancreatitis of unknown cause
  • Biliary stenting
  • Nasobiliary drainage
  • Drainage of pancreatic pseudocyst

Side Effects from ERCP

While most ERCPs are performed with minimal side effects, 5-7% of the procedures can have complications, such as

  • Pancreatitis
  • Bleeding
  • Cholangitis
  • Perforation of the intestine

Source: Mahalingam, S., Langdon, J., Muniraj, T., Do, A., Guo, Y., Spektor, M., & Mathur, M. (2021). Endoscopic Retrograde Cholangiopancreatography: Deciphering the Black and White. Current Problems in Diagnostic Radiology, 50(1), 74–84. https://doi.org/10.1067/j.cpradiol.2020.01.001