Endoscopic retrograde cholangiopancreatography during pregnancy

Physiologic changes of pregnancy leave women at increased risk for gallstone complications. Endoscopic retrograde cholangiopancreatography (ERCP) during pregnancy was first reported in 1990 for the treatment of complicated gallstone disease. Since then, numerous reports have shown that if certain precautionary measures are taken, therapeutic ERCP can be safely performed during pregnancy. A multidisciplinary approach that involves obstetrics, surgery, and gastroenterology is necessary to help ensure maternal and fetal safety. This article addresses the physiologic changes that increase a women's risk for gallstone complications, the indications for ERCP, the safety of ERCP, and its use within the last 15 years.