Endoscopic retrograde cholangiopancreatography (ERCP) is a minimally invasive procedure for diagnosis and treatment of biliary and pancreatic disease that even in expert hands can have complications in 2 % – 10 % of cases, with mortality rates of 0.5 % – 1 % [1] [2]. Pancreatitis, cholangitis, perforation, and bleeding from papillotomy have been the most frequently described complications.