Endoscopic Retrograde Cholangiopancreatography (ERCP), also known as Papillotomy, or Endoscopic sphincterotomy was first used in the 1970s. This technique is operated for the diagnosis and treatment of several diseases pertaining to the liver, pancreas and bile ducts.

The technique of ERCP enables physician to examine the pancreatic and bile ducts. A flexible, lighted tube (endoscope) as thick as the index finger is introduced into the duodenum through an opening (ampulla) via the oral route. A small plastic tube (cannula) is passed through the endoscope into this opening. The doctor then injects a dye or contrast material followed by X-ray studies of the ducts of the pancreas and liver.

ERCP is a convenient diagnostic procedure to evaluate the conditions of the pancreas or bile ducts, and is also useful in treating those conditions. It helps physicians in clearing up abnormal results obtained from other tests such as blood tests, ultrasound, or CT scan. An ERCP is advised in case of weight loss, abdominal pain, jaundice (yellowing of the skin), or the presence of stones or a mass revealed in an ultrasound or CT scan of these organs.

ERCP also helps in determining the requirement for surgery or the most appropriate type of surgical procedure.

To make the examination more comfortable, the patient is sedated during the course of action. Before starting the analysis, a local anesthetic is sprayed into his throat causing numbness in order to prevent gagging. Medications are introduced into the body via the intravenous route for inducing instant relaxation for the entire procedure which usually lasts for 30-60 minutes. The patient is placed on an X-ray table in a comfortable position. Insertion of an endoscope follows. The endoscope is gently passed through mouth, running down the esophagus, and into the stomach and duodenum.

In the next step, air is injected into the duodenum via the scope. This allows the doctor to have a better vision of the inside. The doctor moves the scope forward until it reaches the spot where the pancreatic and bile ducts drain into the duodenum. A thin tube (catheter) is introduced through the scope into that area, followed by the injection of a contrast material into the bile or pancreatic ducts. Several X-rays are then performed.

After completion of the examination, the patient is observed in the endoscopy area for duration of 1-2 hours until the activity of the sedatives worns off. The patient may feel bloated, experience soreness of throat for a couple of days and notice a temporary change in his bowel habits.