Why ERCP is done
- Removing bile duct stones
- Relieving jaundice from a blocked duct with a stent
- Treating bile leaks after gallbladder surgery
- Taking samples from a bile duct narrowing
- Selected pancreatic duct problems in chronic pancreatitis
Today ERCP is used almost only for treatment. For diagnosis, MRCP and EUS are safer, so we use those first when the diagnosis is uncertain.
How it's done
- You're given deep sedation or anaesthesia and lie on your front or side.
- A side-viewing scope is passed through the mouth to the duodenum, next to the papilla.
- A thin tube is passed into the duct and contrast dye is injected to see it on X-ray.
- The opening may be widened with a small cut (sphincterotomy), and stones are pulled out with a balloon or basket, or a stent is placed.
It usually takes 30–60 minutes.
Preparing
Nothing to eat for 6 hours beforehand. Blood thinners may need to be paused; please tell us well in advance. Blood tests, including clotting, are usually checked. See preparing for your procedure.
Risks, honestly
| Risk | What published studies report |
|---|---|
| Post-ERCP pancreatitis | The most common complication, roughly 3–10% depending on the situation; most cases are mild. Medicines and techniques are used to reduce it. |
| Bleeding | Uncommon; usually after a sphincterotomy, and usually stopped endoscopically. |
| Infection (cholangitis) | Uncommon; antibiotics are used when needed. |
| Perforation | Rare. |
These risks are discussed with you before consent. ERCP is offered when its benefit clearly outweighs them.
Afterwards
You're observed for a few hours. Many people stay overnight. Clear fluids first, then food if all is well. Belly pain that keeps getting worse, fever or black stools after ERCP should be reported immediately.
Common questions
Will I need surgery after ERCP?
If the stones came from your gallbladder, gallbladder removal is usually advised later, to stop new stones coming down. ERCP itself has no cut.
Will I have a stent? Does it need removal?
Sometimes. Plastic stents are usually removed or changed within about 3 months. You'll get a written reminder; please don't miss it.
Can ERCP be done if I've had stomach surgery?
Sometimes it's more complex. Alternatives such as EUS-guided procedures may be considered.