This examination will be done when there is a likelihood of strictures or stones in the bile duct or special diseases of pancreas. Residing pain in the abdomen area or in the right upper stomach, sometimes combined with sickness and vomiting, are indications for a hepatic colic or gallstones in the gallbladder or in the bile duct.
First of all the doctor will make a blood test and inspect the gallbladder using ultrasound as a preliminary examination. When gallstones are detected, an ERCP is required to  locate their exact position and if possible, to remove them.

At first, the endoscope 1) is inserted through the mouth and then through the oesophagus 2) before reaching the stomach 3) and finally the duodenum. It will be positioned at the papilla 7), the common excretory duct or bile duct and pancreas. A thin probe (a second small endoscope) can be inserted into the channel of the endoscope and filled with a contrast medium. With the help of an X-ray picture, together with the view through the endoscope, the diagnosis can be made.

4) Liver
5) Pancreas
6) Gallbladder

Therapy
If the X-ray picture indicates the existence of a stone in the bile duct, it can be directly removed:

The stone will be caught in a stone removal basket and eliminated. If it is a large stone, it can be reduced to small pieces by the use of a lithotripter (stone reducer) which is either mechanical or ultrasound.
It is even possible to treat strictures / narrowings in the bile duct via a small tube (stent) being placed directly in the duct.

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