The largest risk associated with ERCP is pancreatitis (generally a 5-10% risk).

Pancreatitis is inflammation of the pancreas and can cause severe abdominal pain associated with nausea and vomiting requiring admission to the hospital for intravenous fluids and narcotics for pain control. Sometimes, the physician will place a small, temporary plastic stent within the pancreatic duct to reduce the risk of post-ERCP pancreatitis.

If a pancreatic stent is placed, an abdominal X-ray is performed within 2-4 weeks to determine if the stent has spontaneously migrated into the intestinal tract or remains within the pancreatic duct. If the stent remains in the pancreatic duct, the stent will need to be retrieved with a repeat upper endoscopy.

Other potential complications include bleeding, infection, ductal injury and perforation. However, these complications are less frequent than pancreatitis.