Endoscopic Retrograde Cholangiopancreatography (ERCP)

ERCP stands for endoscopic retrograde cholangiopancreatography. In this procedure, a thin, lighted tube (endoscope) is used. It is passed through the mouth and down the back of the throat into the upper part of the intestine, called the duodenum. A small, plastic tube (cannula) is then passed through the endoscope. It is directed into the bile duct or pancreatic duct. Dye is then injected through the tube. X-rays are taken to study the biliary and pancreatic passageways. This procedure is used to diagnosis many diseases of the pancreas, bile ducts, liver, and gallbladder.


  • Allergies to food or medicine.

  • Medicines taken, including vitamins, herbs, eyedrops, over-the-counter medicines, and creams.

  • Use of steroids (by mouth or creams).

  • Previous problems with anesthetics or numbing medicines.

  • History of bleeding problems or blood clots.

  • Previous surgery.

  • Other health problems, including diabetes and kidney problems.

  • Possibility of pregnancy, if this applies.

  • Any barium X-rays during the past week.


  • Do not eat or drink anything, including water, for at least 6 hours before the procedure.

  • Ask your caregiver whether you should stop taking certain medicines prior to your procedure.

  • Arrange for someone to drive you home. You will not be allowed to drive for several hours after the procedure.

  • Arrive at least 60 minutes before the procedure or as directed. This will give you time to check in and fill out any necessary paperwork.


  • You will be given medicine through a vein (intravenously) to make you relaxed and sleepy.

  • You might have a breathing tube placed to give you medicine that makes you sleep (general anesthetic).

  • Your throat may be sprayed with medicine that numbs the area (local anesthetic).

  • You will lie on your left side. The endoscope will be inserted through your mouth and into the duodenum. The tube will not interfere with your breathing. Gagging is prevented by the anesthesia.

  • While X-rays are being taken, you may be positioned on your stomach.

During the ERCP, the person performing the procedure may identify a blockage or narrowed opening to the bile duct. A muscular portion of the main bile duct may be partially cut (sphincterotomy). A thin, plastic tube (stent) will be positioned inside your bile duct. This is to allow fluid secreted by the liver (bile) to flow more easily through the narrowed opening.


  • You will rest in bed until you are fully conscious.

  • When you first wake up, your throat may feel slightly sore.

  • You will not be allowed to eat or drink until numbness subsides.

  • Once you are able to drink, urinate, and sit on the edge of the bed without feeling sick to your stomach (nauseous) or dizzy, you may be allowed to go home.

  • Have a friend or family member with you for the first 24 hours after your procedure.


  • You have an oral temperature above 102° F (38.9° C).

  • You develop other signs of infection, including chills or feeling unwell.

  • You have abdominal pain.

  • You have questions or concerns.


  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.