**1. Introduction**

Endoscopic Retrograde Cholangiopancreatography (ERCP) has been employed in the diagnosis and management of biliary tract and pancreatic diseases over the years with the first diagnostic ERCP performed in 1968 by McCune and colleagues [1]. With the presence of less invasive diagnostic procedures such as Contrast enhanced Computed Tomography (CT), abdominal ultrasound, Endoscopic Ultrasound (EUS), Magnetic Resonance Cholangiopancreatography (MRCP) and better blood biomarkers, the popularity of ERCP as a diagnostic procedure has reduced overtime due to the ERCP-associated complications such as pancreatitis, bleeding which negatively impact its relevance as a routine diagnostic tool in pancreatic and bile duct pathologies. Preference has now shifted to the less risky non-invasive diagnostic procedures that involve no duct instrumentation.

The most common causes of acute pancreatitis are gallstones (40–70%) and alcohol (25–35%) [2]. ERCP is mainly utilized in management of gall stone pancreatitis especially among patients with cholangitis, biliary obstruction and pancreatic duct disruption. ERCP also has wide applications in the diagnosis of ductal changes in chronic pancreatitis with application of EUS in diagnosis of the parenchymal changes and intraductal stones with high accuracy. ERCP and EUS also have roles in diagnosis and management of various acute, subacute and chronic pancreatitis

etiologies (such as intraductal gall stones, sphincter of Oddi dysfunction) and complications (such as pancreatic duct leaks, pancreatic pseudocysts) among others.

The potential benefits must be weighed against the associated risks of complications when selecting patients to undergo ERCP or its different therapeutic interventions.
