Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure that combines upper gastrointestinal endoscopy and x-rays to treat problems of the bile and pancreatic ducts.

What are the bile and pancreatic ducts?
Ducts are tubelike structures in the body that carry fluids. The bile ducts carry bile, a liquid the liver makes to help break down food. A group of small bile ducts—called the biliary tree—in the liver empties bile into the larger common bile duct. Between meals, the common bile duct closes and bile collects in the gallbladder—a pear-shaped sac next to the liver.

The pancreatic ducts carry pancreatic juice, a liquid the pancreas makes to help break down food. A group of small pancreatic ducts in the pancreas empties into the main pancreatic duct.

When is ERCP used?
ERCP is used when it is suspected a person’s bile or pancreatic ducts may be narrowed or blocked due to

• Tumors
• Gallstones that form in the gallbladder and become stuck in the ducts
• Inflammation due to trauma or illness
• Infection
• Valves in the ducts, called sphincters, that won’t open properly
• Scarring of the ducts, called sclerosis
• Pseudocysts—accumulations of fluid and tissue debris

What are the risks associated with ERCP?
Significant risks associated with ERCP include

• Infection
• Pancreatitis
• Allergic reaction to sedatives
• Excessive bleeding, called hemorrhage
• Puncture of the G.I. tract or ducts
• Tissue damage from radiation exposure
• Death, in rare circumstances