ERCP accesses bile and pancreatic ducts to diagnose and treat obstruction
A catheter passes through an endoscope into the duct opening in the duodenum. Contrast and X-ray imaging show the ducts while small tools remove stones, dilate strictures, sample tissue or place stents.
Because ERCP can cause serious complications, MRCP or EUS often answers purely diagnostic questions first. Urgent drainage may be lifesaving in cholangitis.
The plan should state whether ERCP will remove a stone, drain infection, treat a leak, sample a stricture or place a temporary or permanent stent.
Who may be considered?
Specialist review may help when the diagnosis, symptoms and previous treatment create a focused question about ERCP.
- Common bile-duct stone requiring extraction.
- Obstructed infected bile duct needing drainage.
- Benign or malignant stricture requiring sampling or stenting.
- Selected pancreatic-duct leak, stone or narrowing.
What the specialist team must confirm
Review includes liver and pancreatic tests, ultrasound CT MRCP or EUS, infection and cultures, previous surgery or ERCP, altered anatomy, pregnancy possibility, allergies, anticoagulation and individual risk of pancreatitis, bleeding and sedation problems.
Key points for this treatment

From noninvasive imaging to targeted duct therapy
ERCP is most appropriate when its ability to treat the problem justifies the risk of pancreatitis and other complications.
Pain, fever and stent plans require attention
Patients are observed for pancreatitis, bleeding, perforation, infection and sedation effects. Some results are immediate, while brushings or biopsies take longer.
Temporary pancreatic or biliary stents require documented removal or exchange. Persistent jaundice or fever may mean drainage is incomplete or the stent has blocked.

Risks, limits and realistic expectations
Risks include pancreatitis, bleeding, cholangitis, cholecystitis, perforation, aspiration and sedation complications. Cannulation or complete treatment may fail and repeat or alternative drainage may be required.
Severe or worsening abdominal pain, fever, vomiting, jaundice, black stool, vomiting blood or breathing difficulty after ERCP requires urgent local care.
