ERCP is a combined endoscopy and X-ray procedure to examine the bile ducts and the pancreatic duct. These are the tubes that drain the liver and the pancreas into the gut.

During ERCP anesthesia is administered to maintain patient comfort. A flexible video endoscope is passed through the mouth to the duodenum. A catheter is then passed through the scope and into the bile duct and/or pancreatic duct. Contrast is injected to show the ducts on X-ray. A cut (sphincterotomy) is often made where the bile duct enters the duodenum; this allows stones to be removed with a balloon device or a basket. Plastic or metal tubes called stents can also be placed in the bile duct to relieve blockages.

ERCP is recommended as a less invasive alternative to surgery when the bile ducts are blocked or thought to contain stones.

ERCPs are performed at Marin General Hospital.