If a problem with the biliary system is suspected by your healthcare provider, an ERCP may be recommended. This endoscopic retrograde cholangiopancreatography is a type of endoscopic imaging test that allows for evaluating the bile ducts and the pancreatic ducts. In general before the procedure, we recommend to not eat anything for eight hours prior to. Blood thinner should be held for an appropriate length of time determined by your endoscopist. Any allergies (especially to contrast) should be reported prior to the procedure date. A small tube with a camera on the end is passed through the mouth, down the throat and into the small intestine while you are under sedation. It is through this small tube that even-smaller instruments are passed to reach the bile duct or pancreatic duct, depending on the issue at hand. Contrast is then injected into the ducts to help visualize your biliary tree or pancreatic duct on X-ray. Primarily, blockages from gall stones, tumors or scar tissue are then able to be found and treated in real time. Following the procedure, you should have your driver bring you home. Anesthesia may take up to 24 hours to wear off. Sore throat, a bloated stomach and nausea may occur immediately after, but is generally mild and wears off quickly.