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Endoscopic retrograde cholangiopancreatography (ERCP)

ERCP is a combination of an endoscopy procedure and x-ray imaging. The gastroenterologist can both diagnose and treat problems in the pancreas and bile ducts.

First, an endoscope is guided down the patient’s throat and into the stomach. Then, the doctor inserts a colored dye into the bile ducts so that they will appear on an x-ray image. The video footage taken by the camera on the tip of the endoscope plays back on a computer monitor that the doctor watches to find abnormalities and the x-ray images can show blockages or narrowing of the bile ducts.


The gastroenterologist can treat blockages or narrowing found in the bile ducts during ERCP. Specialized tools are inserted through the endoscope to:

  • Take tissue biopsies;
  • Break up bile duct stones;
  • Remove tumors or diseased tissue;
  • Place stents.


The gastroenterologist will recommend ERCP if a patient’s bile or pancreatic ducts:

  • Are blocked or narrowed by bile duct stones;
  • Tumors are growing;
  • Inflammation is present, possibly due to infection or trauma;
  • The ducts are scarred (sclerosis);
  • Fluid builds up in unhealthy locations.


The patient will have local anesthetic sprayed on their throat before the ERCP procedure.

The gastroenterologist will give the patient instructions for food and drink that can be consumed the day before the procedure. The patient cannot eat or drink the day of the procedure.

Certain medications may not be allowed before the procedure.

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St. Louis, MO 63110
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