Background: Endoscopic Retrogarde Cholangiopancreatography is direct contrast study of hepatobiliary system by combining the use of endoscopy and fluoroscopy. It has added advantage of allowing duodenoscopy and pancratography which are helpful in diagnosis of Ampulary and Periampullary anomalies. This procedure can be performed in presence of ascites and hepatic malignancies. At present Endoscopic Retrograde cholangiopancreatography is more commonly used as therapeutic tool rather than diagnostic tool. Method: The present study was undertaken at a tertiary referral centre for duration of two years. A total of 40 cases, who underwent ERCP for various indications were included. Once patient was in the procedure room, baseline vital signs are recorded and an intravenous line started. Antibiotic prophylaxis was given at this time. ERCP performed with the patient on the x-ray table with radiological equipment and fluoroscopy at hand. Result: Choledocholithiasis 36% was the most common indication for ERCP. Successful extraction of CBD calculi was done in 78.57% cases. Biliary sphincterotomies was done in 92.5% (37) of the patients for successful drainage. Overall complication rate of ERCP was 12.5%. During this study Sensitivity of the biopsy was 57% while that of brush cytology was 40% and combined sensitivity was 60%. Conclusion: ERCP is effective for the pallation of malignant biliary obstruction, for which self – expanding metallic stents have longer patency than plastic stents. It helps in diagnosis, identification and palliation of post operative biliary leaks. Morbidity and mortality following ERCP biliary drainage is low as compared to surgical biliary drainage.

Keywords: Endoscopic Retrograde Cholangiopancreatography; Hepatobiliary system; Pancreas; Diagnostic; Therapeutic