ERCP (Endoscopic Retrograde Cholangiopancreatography)
ERCP is a combined endoscopy and X-ray procedure used to diagnose and treat problems of the bile ducts and pancreatic duct. A flexible endoscope is passed through the mouth to the small bowel, dye is injected to outline the ducts on X-ray, and fine instruments remove stones, relieve blockages or place stents.
Medically reviewed by the Florence Healthcare medical team · Last reviewed June 2026
Overview
ERCP (endoscopic retrograde cholangiopancreatography) combines a flexible endoscope with live X-ray to examine and treat the tubes that drain the liver, gallbladder and pancreas. A thin tube is passed through the mouth, down the food pipe and stomach into the first part of the small bowel, where the bile and pancreatic ducts open. Contrast dye is injected so the ducts show up clearly on X-ray, revealing stones, narrowings or blockages.
In the same session, the doctor can treat what they find. Bile-duct (gallstone) stones can be removed, a narrowed or blocked duct can be widened, and a small tube called a stent can be placed to keep a duct open — for example, where a narrowing or tumor is squeezing it. Because it treats as well as diagnoses, ERCP is used far more often for treatment than for diagnosis alone, since imaging such as MRCP can usually make the diagnosis without an endoscope.
For international patients, a dedicated coordinator arranges the evaluation and provides a written plan and a transparent, itemized cost estimate before you travel. Our gastroenterologists can review your reports and imaging remotely first, so we confirm that ERCP is the right step for your case and explain what it involves before you commit to the journey.
Who is a candidate?
- People with bile-duct stones causing pain, jaundice or infection
- Blockage of a bile or pancreatic duct that needs to be relieved or stented
- A narrowing (stricture) of a duct, whether from scarring or a tumor, that needs treatment
- Yellowing of the skin or eyes (jaundice) traced to a duct problem
- Bile leaks or duct injuries, sometimes after gallbladder surgery
- Selected cases where tissue or fluid samples are needed from the ducts
What happens
- 1
Assessment
Your specialist reviews your symptoms, blood tests and imaging such as ultrasound or MRCP to confirm ERCP is appropriate and to plan what treatment may be needed during it.
- 2
Preparation
You fast for several hours beforehand. You are told which medicines to pause, especially blood thinners, and sedation is arranged so you are comfortable and relaxed throughout.
- 3
The procedure
Under sedation, the endoscope is passed through the mouth to the small bowel. Dye is injected to outline the ducts on X-ray, and instruments passed through the scope remove stones, widen narrowings or place a stent as needed.
- 4
Recovery and observation
You are monitored as the sedation wears off and watched for a period to check for side effects such as abdominal pain. Many people go home the same day; some stay overnight.
- 5
Follow-up
Your team explains the findings and any next steps, such as later gallbladder removal or a planned return to change a stent. International patients receive written results and remote follow-up support.
Benefits
- Diagnoses and treats duct problems in a single session, without open surgery
- Can clear bile-duct stones and relieve painful or dangerous blockages
- Allows stents to be placed to keep a narrowed duct open
- Can quickly relieve jaundice caused by a blocked bile duct
- Usually done through the mouth with no external incisions and often as a day case
Risks & considerations
- Pancreatitis (inflammation of the pancreas) — the main risk, which can occasionally be severe
- Bleeding, particularly if a small cut is made to widen the duct opening
- Infection of the bile ducts (cholangitis), sometimes needing antibiotics
- Rarely, a tear (perforation) of the bowel or duct that may require further treatment
- The usual risks of sedation, which the team monitors closely throughout
Conditions this treats
Where it is performed
This procedure is delivered by our Gastroenterology.
Learn more before you decide
Provider-reviewed guides on the related conditions, symptoms and tests in our Health Library.
ERCP (Endoscopic Retrograde Cholangiopancreatography) — frequently asked questions
It is used to find and treat problems of the bile ducts and pancreatic duct — commonly removing bile-duct (gallstone) stones, relieving blockages, and placing stents to keep a narrowed duct open, including where a tumor is pressing on it.
ERCP is done under sedation, so you are relaxed and comfortable and usually remember little of it. Occasionally general anesthesia is used. Your team explains which is planned for you beforehand.
You should not feel pain during the procedure because of the sedation. Afterward you may have a mildly sore throat or some bloating from the air used, and most people feel back to normal within a day or two.
A gastroscopy simply looks at the food pipe, stomach and first part of the small bowel. ERCP goes further by injecting dye and using X-ray to examine and treat the bile and pancreatic ducts that drain into the bowel.
The main risk is pancreatitis, inflammation of the pancreas, which is usually mild but can occasionally be more serious. Bleeding, infection of the bile ducts and, rarely, a small tear are also possible. Your team takes steps to reduce these risks and watches you closely.
ERCP is often a day-case procedure, though some people stay overnight, and your coordinator confirms the timeline for your case. We provide a transparent, itemized estimate after reviewing your case and do not quote fixed prices online because each plan is individual.
Related treatments
Considering ercp (endoscopic retrograde cholangiopancreatography)?
Share your reports for a medical second opinion and a transparent, itemized cost estimate — usually within 48 hours.