ERCP (or endoscopic retrograde cholangiopancreatography) is a procedure whereby a flexible endoscope (telescope) is inserted via the mouth to gain access to both the pancreatic and bile duct. The procedure is performed either under general anaesthetic or enhanced sedation and it allows for the operator to perform a variety of diagnostic and therapeutic procedures on the upper GI tract. Stones can be removed from both the bile duct and pancreatic duct and a variety of stents can be inserted into either duct to relieve obstruction. In the vast majority, patients are treated as daycases and it is a safe and effective procedure. In a very small proportion (between 0.2 and 1%) complications such as bleeding, perforation or pancreatitis can occur and very occasionally these can be life-threatening. Mr Worthington is an acknowledged expert in this procedure and has performed well over fifteen hundred cases with excellent results.