What is ERCP? We often hear hepatobiliary surgeons mention ERCP technology, saying that it is one of the main means of minimally invasive treatment of biliary and pancreatic diseases, but what exactly is ERCP technology, ERCP technology, simply put, is to insert a duodenoscope through the mouth, along the digestive tract, into the descending duodenum, where the opening for bile and pancreatic fluid drainage is found, which we call the large papilla, and through the large papilla After inserting special instruments through the opening of the greater papilla, treatment of bile duct diseases and some pancreatic diseases can be completed. The most common disease treated with this technique is common bile duct stones. This technique was first used abroad in the 1970s and was mainly used for the diagnosis of bile duct diseases at the beginning. Later, in the 1980s, based on the gradual proficiency of ERCP technique, the duodenal papillary sphincterotomy (EST technique) was introduced and started to be used for the treatment of common bile duct stones. The specific method is to apply a special incision knife to cut and enlarge the opening of the bile duct in the large papilla, and then insert a lithotomy mesh basket to trap the stone and drag it to the intestine, where it can be excreted with the stool. This technique was introduced to China in the late 1980s and carried out in a few large hospitals in China. After decades of continuous development, and with the advancement of technology, improvement of endoscopic techniques and upgrading of equipment, ERCP technique has developed from a diagnostic technique to one of the most important techniques for minimally invasive treatment of bile duct and pancreatic diseases, and is regarded as “the paragon of minimally invasive surgery in the 20th century”. It is regarded as “the paradigm of minimally invasive surgery in the 20th century”. In recent years, with the improvement of endoscopic mechanical lithotripsy and choledochoscopic laser lithotripsy, most of the common bile duct stones can be treated by ERCP technology without surgery. In particular, therapeutic techniques such as endoscopic nasobiliary drainage (ENBD) and endoscopic endobiliary stent implantation and drainage (ERBD), which are extended from the ERCP technique, are beginning to be used in the palliative treatment of obstructive jaundice caused by hepatobiliary and pancreatic tumors without surgical conditions. And the bulk case data showed no significant difference in survival between ERCP for jaundice due to malignant tumors and conventional surgical treatment of tumors, but the quality of life of patients was significantly better than that of the surgical group. Advantages of ERCP Common bile duct stones are common in China and are usually removed by open choledochotomy in most hospitals. With the improvement of medical technology and equipment. Some hospitals have carried out laparoscopic choledochoscopy and duodenoscopic treatment of common bile duct stones, but they are prone to serious complications such as biliary tract injury and biliary fistula, and the advantages of minimally invasive surgery are not obvious, and the chance of open transit is high. The traditional open surgery or laparoscopic bile duct exploration for stone extraction in common bile duct stones has long operation time and long hospital stay. Compared to surgery, ERCP is a minimally invasive interventional treatment method, and along with the continuous improvement of ERCP technology, duodenoscopy and related supporting equipment, the treatment technology is becoming more and more mature. Duodenoscopy has the advantages of minimally invasive, less patient pain, less complications and mortality, quick recovery, general anesthesia without intubation, etc. It is safe, effective, simple, and with few complications, while maintaining the integrity and physiological function of the biliary system. It has become the preferred method for the treatment of common bile duct stones. This technique is not limited by the adhesions around the bile ducts after multiple surgeries and the patient’s old age and frailty, and is superior to surgical dissection and non-surgical treatment methods combining Chinese and Western medicine, and is favored by medical practitioners and patients. Duodenoscopic technology for the treatment of common bile duct stones is significantly shorter than open surgery (open surgery takes about 120 min on average, endoscopic stone extraction takes about 20 min on average, hospitalization time is greatly shortened (open surgery takes about 12 days on average, endoscopic treatment takes about 7 days on average), hospitalization cost is less than open surgery, and there are no serious complications of surgery. Thus, the treatment of common bile duct stones under duodenoscopy is safe, effective, and can achieve good therapeutic results while saving the limited medical resources of society. Qiu Changcheng, Department of General Surgery, Gaomi People’s Hospital At present, I have carried out several cases of this type of treatment on my own since the ERCP technique was introduced this year, including patients with acute severe obstructive cholangitis due to common bile duct stones.