- 3304 Colorado Blvd, Suite 202, Denton, TX 76210
- Serving Denton · Lewisville · Coppell
What Is ERCP? Procedure, Recovery and Risks Explained
- Comprehensive Gastroenterology P.A.
- October 21, 2026
- 8 min read
Quick Answer
ERCP (endoscopic retrograde cholangiopancreatography) is an advanced procedure that combines endoscopy and X-ray imaging to find and treat problems in the bile ducts and pancreatic duct. It is most often used to remove bile duct stones, open blockages with stents and take tissue samples, usually without open surgery. Most procedures take 30 to 90 minutes.
ERCP at a Glance
Key facts patients ask about
What Does ERCP Stand For?
ERCP stands for endoscopic retrograde cholangiopancreatography. That long name describes what happens:
- Endoscopic: a thin, flexible scope is passed through the mouth into the small intestine.
- Retrograde: contrast dye is injected backward into the ducts.
- Cholangio-pancreatography: X-ray pictures of the bile ducts (cholangio) and pancreatic duct (pancreato).
How Bile Flows
Understanding the anatomy helps explain why blockages cause symptoms
Makes bile to help digest fats.
Stores bile between meals.
Carries bile toward the small intestine. Stones can get stuck here.
The small opening where the bile and pancreatic ducts drain into the duodenum. ERCP is performed through this opening.
Why Is ERCP Done?
ERCP is used when imaging such as ultrasound, CT or MRI shows a problem in the bile or pancreatic ducts that needs treatment.
Conditions Treated with ERCP
ERCP vs. MRCP vs. EUS
These tests are often mentioned together. Here is how they compare.
| Test | What It Is | Can It Treat? | Best For |
|---|---|---|---|
| ERCP | Endoscopy plus X-ray with contrast dye | Yes: removes stones, places stents, takes samples | Treating known duct problems |
| MRCP | A specialized MRI scan of the bile and pancreatic ducts | No, imaging only | Non-invasive diagnosis |
| EUS | Endoscopy with an ultrasound probe on the tip | Biopsy and some drainage procedures | Detailed imaging of the pancreas and small stones |
Your gastroenterologist will choose the right test based on your symptoms and prior imaging.
How to Prepare for ERCP
- Fast before the procedure as instructed, usually nothing to eat for several hours.
- Review your medications, especially blood thinners, diabetes medicines and weight-loss injections.
- Tell us about allergies, including reactions to contrast dye or sedation.
- Arrange a ride home and plan to rest for the remainder of the day.
What Happens During ERCP
Step by Step
What to expect on the day of your procedure
You meet the team, review consent and receive an IV.
You are made comfortable and sleepy.
The endoscope is guided to the papilla in the duodenum.
Contrast dye shows the ducts on X-ray. Stones may be removed, a small cut (sphincterotomy) made, or a stent placed.
You are monitored until the sedation wears off. Some patients stay overnight.
Recovery After ERCP
- Sore throat or bloating is common for a day.
- Diet: you usually start with clear liquids and advance as directed.
- Activity: no driving for the rest of the day after sedation.
- Stents: plastic stents usually need to be removed or exchanged later. Keep your follow-up appointment.
Risks of ERCP
ERCP is generally safe when performed by an experienced endoscopist, but it carries more risk than routine endoscopy.
| Possible Complication | About | Warning Signs |
|---|---|---|
| Pancreatitis | The most common complication, occurring in roughly 3 to 5 percent of procedures overall and more often in some higher-risk patients | Severe upper abdominal pain, nausea, vomiting |
| Bleeding | Uncommon, usually related to sphincterotomy | Black stools, vomiting blood, dizziness |
| Infection | Uncommon; antibiotics may be given | Fever, chills |
| Perforation | Rare tear in the intestine or ducts | Severe pain, fever |
Call our office or seek urgent care if you develop severe pain, fever, vomiting or bleeding after ERCP.
ERCP in Denton, TX
Dr. Amjad Awan performs ERCP at Medical City Denton, Medical City Lewisville and Texas Health Presbyterian Hospital Denton. Call (940) 243-0912, request an appointment, or learn more about ERCP in Denton.
Frequently Asked Questions
Is ERCP painful?
You receive sedation or anesthesia, so most patients feel little or nothing. A sore throat or bloating afterward is common.
How long does ERCP take?
Most ERCP procedures take between 30 and 90 minutes, depending on the treatment needed.
Will I stay in the hospital?
Many patients go home the same day. Some stay overnight for observation.
Is ERCP surgery?
No. ERCP is an endoscopic procedure with no skin incisions, although it can often treat problems that once required surgery.
When do stents come out?
Plastic stents are usually removed or exchanged within a few months. Dr. Awan will schedule the right timing for you.
Disclaimer: This article is for general education and does not replace professional diagnosis or treatment. If you have symptoms or questions about your digestive health, please talk with a qualified healthcare provider.
Contact Our Office
Dr. Awan has cared for patients in Denton County for 25 years with Comprehensive Gastroenterology P.A. He provides colonoscopy, upper endoscopy, ERCP, endoscopic ultrasound and treatment for the complete range of digestive, liver and pancreatic conditions, with a focus on clear explanations and personal care.
Table of Contents
Fatty Liver Disease: Causes, Symptoms & Prevention
Protect your liver with early testing and healthy habits. Read more →
When Should You Get a Colonoscopy?
Screening ages, risk factors and what to expect. Read more →
Request an Appointment