Endoscopic Retrograde Cholangio Pancreatography (ERCP) is available to evaluate and treat pancreato biliary disease. ERCP has now replaced surgery in most patients with common bile duct and pancreatic disease as the modality of choice both for diagnosis as well as treatment. Stones in both common Bile Duct and Pancreatic Duct can be removed without surgery by ERCP. Benign and malignant Pancreatic / Biliary structure can also be diagnosed and treated, making surgery unnecessary especially where paliation is the aim.