The pancreaticobiliary system is a series of tubes that connect to the liver, gallbladder, and pancreas, through which bile and digestive juices created by the liver and pancreas pass. It’s an essential part of the digestive system because bile helps absorb fats while also carrying toxins and other waste from the liver.

Sometimes substances in the bile, such as cholesterol and bilirubin, may crystalize and block the ducts. These crystals are commonly called stones. An endoscopic retrograde cholangiopancreatography (ERCP) can treat such stones, as well as other conditions in the pancreatic and bile ducts.

An ERCP combines a commonly used examining procedure, called an upper endoscopy, with X-rays. In an upper endoscopy, the gastroenterologist feeds a thin tube equipped with a light and tiny camera into the patient’s mouth, through the esophagus, then through the stomach, until it reaches the top of the small intestine (duodenum). A special side-viewing endoscope is used to visualize and access the opening of the biliary and pancreatic duct. A dye is then administered through the tube to further examine the ducts under X-ray. If stones are found, a small incision is made at the opening and the stones are removed from the duct using peripheral accessories such as balloons or baskets to clear out the duct.


The patient will be sedated for this procedure and therefore will need a ride home. The patient should also bring a complete list of current medications. Fasting will be required, likely from midnight the night before the procedure. Most patients can get back to their normal routines the next day.

Conditions treated by this procedure:


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