Endoscopic retrograde cholangiopancreatography: maximizing benefits and minimizing risks.

Endoscopic retrograde cholangiopancreatography (ERCP) has become enormously popular throughout the world because of its proven value in the management of patients with known and suspected biliary and pancreatic disease. The results of ERCP are operator dependent, and there are significant risks. Adverse events are more likely when procedures are performed by endoscopists with inadequate training and experience. The best outcomes should occur when procedures are done for the best reasons, using optimal techniques in an ideal environment and a well-trained team, conscious of the risks and the ways to minimize them. This article discusses these intertwining elements of ERCP.