Editing Endoscopic retrograde cholangiopancreatography (section)

==Medical uses==
===Diagnostic===
The following represent indications for ERCP, particularly if or when less invasive options are not adequate or definitive:
[[Image:ERCP stone.jpg|right|thumb|Fluoroscopic image of [[common bile duct]] [[choledocholithiasis|stone]] seen at the time of ERCP. The stone is impacted in the distal common bile duct. A nasobiliary tube has been inserted.]]
[[Image:ERCP dilatation.png|right|thumb|200px|Fluoroscopic image showing dilatation of the pancreatic duct during ERCP investigation. Endoscope is visible.]]
* [[Obstructive jaundice]] – This may be due to several causes
** Gallstones with dilated bile ducts on [[ultrasonography]]
** Indeterminate biliary strictures and suspected [[bile duct tumor]]s<ref>{{cite journal |last1=Tabibian |first1=James H |title=Advanced endoscopic imaging of indeterminate biliary strictures |journal=World Journal of Gastrointestinal Endoscopy |date=2015 |volume=7 |issue=18 |pages=1268–1278 |doi=10.4253/wjge.v7.i18.1268 |pmid=26675379 |pmc=4673389 |doi-access=free }}</ref>
** Suspected injury to bile ducts either as a result of trauma or of [[iatrogenic]] origin
** [[Sphincter of Oddi|Sphincter of Oddi dysfunction]]
* Chronic [[pancreatitis]] is currently a controversial indication due to widespread availability of safer diagnostic modalities including [[endoscopic ultrasound]], [[CT scan|CT]], and [[MRI]]/[[Magnetic resonance cholangiopancreatography|MRCP]]
* [[Pancreatic cancer|Pancreatic tumors]] no longer represent a valid diagnostic indication for ERCP unless they cause bile duct obstruction and jaundice. Endoscopic ultrasound represents a safer and more accurate diagnostic alternative

===Therapeutic===
ERCP may be indicated in the above diagnostic scenarios when any of the following are needed:
* [[Biliary endoscopic sphincterotomy|Endoscopic sphincterotomy]] of the [[sphincter of Oddi]]
* Extraction of gallstones or other [[Biliary sludge|biliary debris]]<ref>{{cite book | chapter-url=https://www.ncbi.nlm.nih.gov/books/NBK539698/ | title=StatPearls | chapter=Biliary Obstruction | year=2022 | publisher=StatPearls | pmid=30969520 | last1=Coucke | first1=E. M. | last2=Akbar | first2=H. | last3=Kahloon | first3=A. | last4=Lopez | first4=P. P. }}</ref>
* Insertion of a [[Self-expandable metallic stent|stent]] through the [[major duodenal papilla]] and [[ampulla of Vater]] into the [[common bile duct]] and/or the [[pancreatic duct]]
* Dilation of [[Stenosis|strictures]] (e.g. [[primary sclerosing cholangitis]], [[Anastomosis|anastomotic]] strictures after liver transplantation)<ref>{{cite journal |last1=Tabibian |first1=James H. |last2=Asham |first2=Emad H. |last3=Han |first3=Steven |last4=Saab |first4=Sammy |last5=Tong |first5=Myron J. |last6=Goldstein |first6=Leonard |last7=Busuttil |first7=Ronald W. |last8=Durazo |first8=Francisco A. |title=Endoscopic treatment of postorthotopic liver transplantation anastomotic biliary strictures with maximal stent therapy (with video) |journal=Gastrointestinal Endoscopy |date=March 2010 |volume=71 |issue=3 |pages=505–512 |doi=10.1016/j.gie.2009.10.023 |pmid=20189508 }}</ref>
* Extraction of [[liver fluke]]s from the biliary system (e.g., [[opisthorchiasis]], [[clonorchiasis]], [[fasciolosis]])