Endoscopic Retrograde Cholangiopancreatography ERCP | MedStar Health

Also known as ERCP, is a procedure used to identify gallstones, tumours, or narrowing in your bile ducts. This procedure is done using an endoscope, which is a thin, flexible tube that can perform multiple tasks, and the introduction of dye to allow your gastroenterologist to accurately diagnose your condition.

ERCP is a highly specialized procedure that should only be performed by experienced, skilled doctors. At MedStar Health, our renowned endoscopic specialists perform a high volume of ERCPs yearly with an excellent success rate.

Why perform an ERCP?

If you are having abdominal pain, especially if it is in the right upper or middle stomach area and accompanied with jaundice (yellowing of the skin and the whites of the eyes), your doctor may want to do an ERCP to identify any problem with the pancreas or bile ducts.

Bile is a digestive fluid that is made and released by the liver and stored in the gallbladder. It helps break down fats into fatty acids so the body can digest them.

Endoscopic sphincterotomy

Sometimes, an endoscopic sphincterotomy (ES) is done at the same time as an ERCP. During a sphincterotomy, your doctor cuts the sphincter muscle of the bile or pancreatic duct to treat many conditions, including gallstones. 


To get an even clearer view of the bile duct and pancreas, your gastroenterologist may perform an ERCP with SpyGlass™, a highly subspecialized procedure where we use a state-of-the-art camera within the actual bile duct itself to take photographs and sample tissue. 

Single Balloon ERCP 

If you have had an operation in the past, including gastric bypass or Billroth’s procedure, your MedStar Health gastroenterologist will perform a highly specialized technique called a single balloon assisted ERCP.

What does the ERCP procedure entail?

Before the procedure:

  • Do not eat or drink after midnight.
  • Remove any jewelry so it does not interfere with the X-ray.
  • Sign a consent form.

During the procedure:

  • An IV line is placed in your arm through which you receive medicines and sedatives.
  • Your throat may be with a numbing medication and a mouth guard will be placed to protect your teeth. If you wear dentures, you will need to remove them.
  • Once the anesthesia takes effect, the doctor starts the procedure by passing the endoscope through your esophagus into your stomach and to the duodenum (first part of the small intestine, closest to the stomach).
  • The doctor passes a catheter (a thin tube) through the endoscope and inserts it into the duct that leads into either the pancreas or the bile duct depending on your symptoms. 
  • A dye is injected into the ducts to highlight any abnormalities, and X-rays are taken. This allows your doctor to see any stones, tumors, or narrowing of the ducts.

Your doctor may use specialized instruments through the endoscope to:

  • Clear any obstruction of the duct into the bowel
  • Stretch out narrow segments
  • Remove gallstones
  • Take a tissue sample for analysis (biopsy)
  • Drain blocked areas

This procedure can be both diagnostic and a form of treatment, depending on your condition.

What is a normal recovery like after an ERCP?

During the procedure, air is used to inflate your stomach and bowel so your doctor has better visualization of the operating field. The air may cause some bloating or gas. You may also experience a sense of a sore throat for a few days after the procedure.

Our providers

Dr Nadim Haddad talks with a patient during an office visit at MedStar Georgetown University Hospital.

Expert gastroenterology care

Getting the care you need starts with seeing one of our gastroenterologists.

Additional Information

Endoscopy and advanced gastroenterology (ERCP/EUS): Ask Dr. Walid Chalhoub

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