Version July 2025
ERCP: endoscopic retrograde cholangiopancreatography; EUS: endoscopic ultrasound; MRCP: magnetic resonance cholangiopancreatography.
* Refer to UpToDate content on considerations in pregnant patients and patients with altered anatomy, including Roux-en-Y gastric bypass.
¶ Cholangitis is suspected in patients with fever, leukocytosis, elevated inflammatory markers, or other sepsis physiology.
Δ Non-urgent ERCP is often performed during the index admission; though it may be performed post-discharge, prior to elective cholecystectomy; or postoperatively, if intra-operative cholangiogram demonstrates a stone.
◊ MRCP is preferred for assessment of stones, but if contraindicated/unavailable, EUS is performed (followed by ERCP in the same procedure, if stones are visualized on EUS).
