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Endoscopic retrograde cholangiopancreatography: Indications, patient preparation, and complications

Andrea Tringali, MD, PhD
Silvano Loperfido, MD
Guido Costamagna, MD, FACG
Section Editor
Douglas A Howell, MD, FASGE, FACG
Deputy Editor
Kristen M Robson, MD, MBA, FACG


Endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic technique in which a specialized side-viewing upper endoscope is guided into the duodenum, allowing for instruments to be passed into the bile and pancreatic ducts. These are opacified by injection of a contrast medium, thereby permitting their radiologic visualization and allowing for a variety of therapeutic interventions. It is a relatively complex endoscopic procedure since it requires specialized equipment and has a long learning curve to develop proficiency. Its benefits in the minimally invasive management of biliary and pancreatic disorders are challenged by a higher potential for serious complications than any other standard endoscopic technique [1].

The use of ERCP appears to be increasing with time. In a population-based study from Olmstead County in the United States, average utilization of ERCP increased from 58 to 105 ERCPs per 100,000 persons per year over a 10-year period from 1997 to 2006 [2].

Similar to other endoscopic procedures, determinants of ERCP procedural safety include [3]:

Indication (appropriate or questionable)

Sedation and monitoring practice

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Literature review current through: Nov 2017. | This topic last updated: Aug 08, 2017.
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