ERCP

Endoscopic Retrograde Cholangiopancreatography

Expert ERCP care in Naples and Bonita Springs — board-certified gastroenterologists diagnose and treat conditions affecting the bile ducts and pancreas, often during the same procedure.

What Is ERCP?

Endoscopic Retrograde Cholangiopancreatography, commonly known as ERCP, is a specialized procedure used to diagnose and treat conditions affecting the bile ducts and pancreas.

The bile ducts carry bile from the liver and gallbladder into the small intestine to help digest fats, while the pancreas produces enzymes that aid digestion. When these ducts become blocked, narrowed, or damaged, they can lead to symptoms such as abdominal pain, jaundice, infection, or pancreatitis.

During ERCP, your physician guides a thin, flexible endoscope through your mouth, stomach, and into the first portion of the small intestine. A contrast dye is then introduced into the bile and pancreatic ducts, allowing them to be evaluated using specialized X-ray imaging.

Unlike many gastrointestinal procedures used only for diagnosis, ERCP can often diagnose and treat certain conditions during the same visit — your gastroenterologist will determine whether it’s the right fit based on your symptoms, history, and prior testing.

Quick Facts

Procedure type

Diagnostic & therapeutic

Sedation

Provided

Length

30–90 min

Recovery

Same-day, most patients

Why Might I Need an ERCP?

Your physician may recommend ERCP when symptoms, lab findings, or imaging suggest a problem involving the bile ducts or pancreas that needs further evaluation or treatment.

Common Symptoms

Yellowing of Skin or Eyes

Jaundice

Persistent Upper Abdominal Pain

Recurrent Pancreatitis

Fever

From suspected bile duct infection

Nausea or Vomiting

Related to bile duct obstruction

Abnormal Liver Function Tests

Gallstones

Blocking the common bile duct

Dilated Bile Ducts

Identified on imaging

ERCP is often recommended after other diagnostic tests — ultrasound, CT, MRI, or MRCP — identify findings that require further evaluation or treatment. Your gastroenterologist reviews your symptoms, history, labs, and imaging to determine whether ERCP is the most appropriate procedure.

Conditions ERCP Can Diagnose & Treat

Detailed imaging of the biliary and pancreatic duct systems, with treatment possible in the same visit

Common Bile Duct Stones

Gallstones lodged in the bile duct, blocking normal flow

Biliary Strictures

Narrowing of the bile ducts that restricts drainage

Blocked Bile Ducts

Obstruction that may require treatment to restore flow

Pancreatitis

Inflammation of the pancreas requiring evaluation

Cholangitis

Infection affecting the bile ducts

Pancreatic Duct Disorders

Conditions affecting the pancreatic duct system

How ERCP Can Treat Certain Conditions

Diagnosis and treatment often happen in the same visit, reducing the need for a second procedure

Removing Bile Duct Stones

Placing Biliary or Pancreatic Stents

Widening Narrowed Ducts

Sphincterotomy

To improve drainage

Obtaining Tissue Samples

For biopsy

Treating Bile Duct Leaks

Managing Pancreatic Duct Disorders

Selected cases

Your ERCP Journey

From your initial consultation through follow-up care, here’s what to expect at each stage.

Consultation

Referral review, insurance verification, prep instructions sent.

Prepare

Fasting, medication adjustments, and arranging a driver.

Day of Procedure

Check-in, vitals, IV sedation, and throat numbing.

During EGD

15–30 minute scope exam; biopsies taken if indicated.

Recovery & Results

1 hour monitoring; results via MyChart or a follow-up call.

Arrange a driver in advance. Because ERCP is performed under sedation, you will not be able to drive yourself home — a responsible adult must take you home after your procedure.

Is This the Right Test for You?

ERCP, MRCP, and endoscopic ultrasound are often discussed together, but each serves a different purpose.

	ERCP	MRCP	Endoscopic Ultrasound (EUS)
Primary purpose	Diagnose and treat bile duct and pancreatic disorders	Non-invasive MRI imaging of bile ducts and pancreas	Detailed imaging of the digestive tract and nearby organs
Sedation	Yes	No	Yes
Can perform treatment?	Yes	No	Limited tissue sampling only

Risks & Safety

Capsule endoscopy is generally safe. Serious complications are uncommon.

Benefits

Often allows diagnosis and treatment in the same visit, reducing the need for additional procedures.

Potential Risks

Uncommon, but may include pancreatitis, bleeding, infection, perforation, or a sedation reaction.

Your Safety

Your physician reviews your history and health beforehand, and your care team monitors you closely throughout.

Contact your physician if you develop severe abdominal pain, fever, persistent vomiting, difficulty swallowing, black stools, or other concerning symptoms after discharge.

Results & Next Steps

Following ERCP, your physician will explain the findings from your procedure and discuss any treatment that was performed.

If tissue samples were collected, lab results may take several days. ERCP is often one step within a broader digestive care plan — your gastroenterology team will continue working with you to determine the most appropriate next steps.

Depending on results, your care plan may include

Continued observation
Medication management
Removal or replacement of stents
Additional imaging studies
Follow-up endoscopic procedures
Referral for surgery when appropriate

Frequently Asked Questions

Is ERCP painful?

ERCP is performed under sedation, so most patients remain comfortable and don’t remember the exam. Some mild bloating or a sore throat afterward typically resolves quickly.

How long does an ERCP take?

Most procedures take approximately 30 to 90 minutes, depending on the reason for the procedure and whether treatment is performed during the exam.

Will I be asleep during ERCP?

Yes. ERCP is performed under sedation so you remain comfortable throughout, with your care team monitoring you closely before, during, and after.

Can ERCP remove gallstones?

Yes. One of the most common reasons ERCP is performed is to remove gallstones lodged in the common bile duct, helping restore normal bile flow.

Is ERCP considered surgery?

No. ERCP is an endoscopic procedure, performed with a thin, flexible scope through the mouth — no surgical incisions are made.

Why did my doctor recommend ERCP instead of surgery?

ERCP can often diagnose and treat bile duct and pancreatic conditions without incisions, which may eliminate the need for surgery or help determine if surgery is the right next step.

How long is recovery after ERCP?

Most patients go home the same day once sedation wears off. Your physician provides specific instructions based on any treatment performed.

When will I receive my results?

Your physician discusses initial findings right after the procedure. If tissue samples were collected, lab results may take several days.

Location

ERCP consultations and follow-up care are available at NCH Gastroenterology outpatient locations.

Explore All Gastroenterology Services

Conditions, screenings, and advanced GI care at NCH.

Take the Next Step

If you’ve been referred for ERCP or are experiencing symptoms related to a bile duct, pancreatic, or gallbladder condition, the specialists at NCH Gastroenterology are here to help determine whether ERCP is right for you.