ERCP can be used to diagnose and treat problems such as jaundice (yellowing of the skin and eyes), cholangitis (inflammation or infection of the bile ducts), pancreatitis, and blockage of the bile ducts caused by gallstones or cancer. ERCP can also be used to diagnose and treat malignant (cancerous) and benign (non-cancerous) bile duct and pancreatic duct strictures, or narrowed regions of the duct.

ERCP is performed with a special type of endoscope, through your mouth, oesophagus and stomach into the duodenum (first part of the small intestine). After seeing the common opening to the ducts from the liver and pancreas (the major papilla) your doctor will pass a narrow plastic tube called a catheter into the ducts, and inject contrast (X-ray dye) into the duct then take X-rays. These X-ray images help with diagnosis and to perform treatments. The treatments performed depend on the underlying problem, and can include removing stones in the bile duct, taking tissue samples, and placing a stent.

ERCP with digital cholangioscopy allows direct visualisation of the bile duct or pancreatic duct with a small endoscope that is inserted into the duct through the ERCP scope. This assists with directed biopsies and treatment of large stones.