ERCP (endoscopic retrograde cholangio-pancreatography)

An ERCP is a test that allows doctors to look at the pancreas, gall bladder and bile duct. They can take a biopsy during the test.

What is an ERCP?

Doctors may use an ERCP (endoscopic retrograde cholangio-pancreatography) to help diagnose pancreatic cancer, gall bladder cancer or bile duct cancer.

The doctor can take a biopsy during the test. They can also put in a stent to treat jaundice during an ERCP.

The organs inside the abdomen (tummy)

The doctor passes a thin, flexible tube called an endoscope down your throat. This goes down into your stomach and into the first part of the small bowel (duodenum).

Having an ERCP

You should not eat or drink anything for 6 hours before the procedure. This is so your stomach and duodenum are empty. The doctor or nurse will give you a sedative to make you feel relaxed and sleepy. They will also use a local anaesthetic spray to numb your throat. Sometimes, doctors do this test under general anaesthetic (while you are asleep).

Your doctor will look down the endoscope. This helps them find the openings where the bile duct and the pancreatic duct drain into the duodenum. They can inject a dye into these ducts that will show on x-rays. This helps them find any abnormalities or blockages.

Biopsies during an ERCP

If there are any abnormal areas, the doctor will take a biopsy. They will then send the biopsy to the laboratory to be examined under a microscope.

They may put a small brush down the endoscope and take biopsies from the tumour. They will then send the brush with the cells on it to a laboratory, to be tested for cancer.

About our information

  • References

    Below is a sample of the sources used in our pancreatic cancer information. If you would like more information about the sources we use, please contact us at

    British Society of Gastroenterology. Guidelines for the management of patients with pancreatic cancer peri-ampullary and ampullary carcinomas. 2005.

    European Society for Medial Oncology. Cancer of the pancreas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, 2015. 26 (Supplement 5): v56 to v68.

    Fernandez-del Castillo. Clinical manifestations, diagnosis, and staging of exocrine pancreatic cancer. UpToDate online. Jan 2018.

    Fernandez-del Castillo C, et al. Supportive care of the patient with locally advanced or metastatic exocrine pancreatic cancer. UpToDate online. Feb 2017. 

    Winter JM, et al. Cancer of the pancreas, DeVita Hellman and Rosenberg’s Cancer: Principles and Practice of Oncology (10th edition). Lippincott Williams and Wilkins. 2016.

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Professor Tim Iveson, Consultant Medical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.