Endoscopic Retrograde Cholangiopancreatography Market Size & Outlook, 2025-2033

Endoscopic Retrograde Cholangiopancreatography Market Overview

The global endoscopic retrograde cholangiopancreatography market size was valued at USD 1.49 billion in 2024 and is expected to grow from USD 1.59 billion in 2025 to reach USD 2.74 billion in 2033, growing at a CAGR of 7% during the forecast period (2025–2033). Growth is supported by the increasing burden of pancreatic and biliary diseases and expanded access to minimally invasive endoscopic techniques.

Key Market Insights

• North America dominated the endoscopic retrograde cholangiopancreatography industry and accounted for a 50% share in 2024.
• Based on product type, the endoscopes segment held the largest share of 36.26% of the market in 2024.
• Based on application, the biliary sphincterotomy segment leads the market with the largest revenue share of 18% in 2024.
• Based on end-user, the hospitals and clinics segment dominates the ERCP market at a 7.8% CAGR.

Market Size & Forecast

• 2024 Market Size: USD 1.49 billion
• 2033 Projected Market Size: USD 2.74 billion
• CAGR (2025–2033): 7%
• Largest market in 2024: North America
• Fastest-growing region: Europe

The diagnostic and therapeutic procedure known as endoscopic retrograde cholangiopancreatography, or ERCP, combines X-ray imaging with upper gastrointestinal (GI) endoscopy to diagnose and treat conditions affecting the bile and pancreatic ducts. The tubes that transport bile from the liver to the gallbladder and then to the duodenum are called bile ducts. These passageways transport pancreatic juice from the duodenum to the pancreas. When bile or pancreatic ducts have become narrowed or blocked, an ERCP procedure may be recommended by a doctor. This may result from gallstones, infection, acute pancreatitis, chronic pancreatitis, pancreatic pseudocysts, cancers of the bile ducts and pancreas, or other conditions.

Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic procedure for diseases affecting the gallbladder, biliary system, pancreas, and liver. ERCP devices use a combination of fluoroscopic imaging and luminal endoscopy to diagnose and treat disorders related to the pancreaticobiliary system. Endotherapy devices are commonly used to treat conditions such as Barrett's disease, biliary disease, colitis, Crohn's disease, gastroesophageal reflux disease (GERD), liver disease, pancreatitis, and inflammatory bowel disease, and peptic ulcer disease.

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Market Drivers

Rising Number of People Suffering from Digestive and Chronic Biliary Disorders

An increase in the prevalence of chronic conditions, the most common of which are Barrett's Disease, Biliary Disease, Colitis, Crohn's Disease, Gastroesophageal Reflux Disorder (GERD), Liver Disease, Pancreatitis, Inflammatory Bowel Disease, and Peptic Ulcer Disease. The most common conditions that make it difficult for patients to go about their daily lives are chronic gastrointestinal and biliary conditions. It is anticipated that an increase in the prevalence of diseases will drive an increase in the demand for treatment, which is anticipated to drive the growth of the market.

Increase in Frequencies of Benign Tumors

Endoscopic retrograde cholangiopancreatography (ERCP) is experiencing a rapid and continuous increase in the number of devices for diagnosing and treating benign liver and pancreas tumors. Some examples of these benign tumors include comorbidities, adenomas, hemangiomas, and focal nodular hyperplasia (FNH). The leading rivals in this market, Olympus Corporation, Hobbs Medical, Inc., Telemed System, Inc., and Becton, Dickinson, and Company, list pancreatic adenocarcinoma as an additional benign pancreatic tumor.

Increase in the Older Population

As the world's population ages faster, there has been a corresponding surge in the number of endoscopic devices used in the field of ERCP. The aging of the population is causing a significant rise in the incidence of visual impairment. As a result, comorbidities like adenomas, hemangiomas, focal nodular hyperplasia (FNH), and pancreatic adenocarcinoma have been observed. Cancer of the pancreas is the fourth most common type of cancer worldwide. According to the National Cancer Database, in the United States, those over 65 make up 68.5% of those diagnosed with pancreatic cancer. Oncologists will see an increasing number of elderly patients with gastrointestinal and chronic biliary disorders and benign liver and pancreas tumors as the elderly population continues to grow. In the coming years, it is anticipated that this will contribute positively to the expansion of the ERCP market.

Market Restraint

High Costs Associated with Treatment from ERCP Devices

Upper gastrointestinal (GI) endoscopy and x-rays are components of the ERCP procedure, which diagnose and treat conditions affecting the bile and pancreatic ducts. High treatment costs are associated with ERCP devices, including sphincterotomes, lithotripters, endoscopes, accessories, stents, cannulas, forceps, snares, catheters, guide wires, balloons, and baskets. These high costs are a significant barrier to the expansion of the market. For endoscopic retrograde cholangiopancreatography (ERCP) diagnostic procedures, disposable equipment accounted for 27% of reimbursement, whereas for ERCP therapeutic procedures, disposable equipment accounted for 68% of reimbursement. Although reimbursement for therapeutic ERCP was higher overall, this was partially offset by the high direct costs associated with disposable equipment, which limited reimbursement's ability to cover indirect costs. Therefore, a rise in the prevalence of disorders alongside an increase in the high costs associated with the treatment provided by ERCP devices is anticipated to reduce the impact and limit the market growth in the future.

Market Opportunity

Rising Awareness Worldwide

The endoscopic retrograde cholangiopancreatography market is experiencing a rapid and continuous increase in diagnostic devices due to comorbidities, such as adenomas, hemangiomas, focal nodular hyperplasia (FNH), Pancreatic adenocarcinoma, Ampullary cancer, and others. An increase in the disorder related to the pancreatic, liver, and bile ducts leads to a surge in awareness of ERCP devices. This provides growth opportunities to the manufacturers, thus boosting the market growth.

Regional Insights

North America dominated the endoscopic retrograde cholangiopancreatography market in 2024 with a 50% share and remains the highest revenue contributor, projected to grow at a CAGR of 7.4% during the forecast period. The United States is responsible for the highest number of endoscopic retrograde cholangiopancreatography (ERCP) procedures in the region where endoscopes, endotherapy devices, imaging systems, and energy devices are utilized. It is anticipated that this will provide a significant opportunity for businesses operating in the market of endoscopic retrograde cholangiopancreatography to grow their customer base and revenue.

Europe Market Trends

Europe is ERCP's second most lucrative market. This can be attributed to the significant burden that pancreatic and bile disorders place on people's overall health. These conditions include gastroesophageal reflux disease (GERD), liver disease, pancreatitis, inflammatory bowel disease, and Crohn's disease. In severe cases, surgical intervention is required to treat these conditions when the diseases have not been detected in their earlier stages. Given that there are untapped markets for ERCP products and pancreatic cancer is more prevalent there, Germany now controls most of the European market for endoscopic retrograde cholangiopancreatography devices.

Asia Pacific Market Trends

The Chinese market dominated the Asia Pacific. Because of Japan's advanced healthcare system, which includes universal health insurance coverage, this region's market has experienced rapid expansion. Countries like China and India concentrated on enhancing medical infrastructure to treat many people with severe illnesses like cancer and tumors. Additionally, growth in the number of endoscopic retrograde cholangiopancreatography (ECRP) equipment makers is expected to increase demand for ECRP devices.

Europe Market Trends

Europe is ERCP's second most lucrative market. This can be attributed to the significant burden that pancreatic and bile disorders place on people's overall health. These conditions include gastroesophageal reflux disease (GERD), liver disease, pancreatitis, inflammatory bowel disease, and Crohn's disease. In severe cases, surgical intervention is required to treat these conditions when the diseases have not been detected in their earlier stages.

Product Type Insights

The endoscopes segment, which accounted for the largest share of 36.26% in 2024, remains the top market contributor with an expected CAGR of 8.8% through the forecast period. Due to an increase in gastrointestinal and chronic biliary disorders, the market for endoscopic retrograde cholangiopancreatography devices for endoscopes is expected to expand significantly over the coming years. According to the World Health Organization, approximately 8 million deaths yearly are caused by gastrointestinal (GI) diseases. Thus, an increase in the disorders related to the bile duct, liver and pancreatic cancer is anticipated to increase the demand for the product in the market. Further, it creates a significant opportunity for endoscopic retrograde cholangiopancreatography device manufacturers to expand their business worldwide. In addition, an increase in healthcare expenditures and favorable administration regulations are anticipated to stimulate the market's growth in the coming years.

Application Insights

The biliary sphincterotomy segment, accounting for the largest revenue share of 18% in 2024, remains the top market contributor with an expected CAGR of 8.1%. A high-frequency current is used to cut the biliary sphincter and the intraduodenal segment of the common bile duct after selective cannulation with a special knife called a sphincterotome inserted into the papilla. This procedure is called biliary sphincterotomy or biliary endoscopic sphincterotomy (EST).

Due to the rising prevalence of obstructive ductal calculi, ductal disruption & leak, sphincter stenosis, and dominant pancreatic stricture in the population, the pancreatic sphincterotomy sector is anticipated to grow at the greatest CAGR throughout the forecast period. The market is also expanding due to the surge in demand for endoscopic procedures used to treat various pancreatic and pancreas-related illnesses.

End-User Insights

The hospitals and clinics segment, the largest contributor in the ERCP market, is projected to grow at a CAGR of 7.8% over the forecast period. Ambulatory surgery centers, also known as ASCs, are specialized medical facilities that provide patients with the option of having surgical procedures and other treatments carried out outside a traditional hospital environment. The ambulatory surgical center's segment is expected to grow the highest during the forecast period, owing to the prevalence of pancreatic cancer, bile duct, and pancreatic duct diseases. These factors are expected to foster the growth of the ERCP market.

List of key players in Endoscopic Retrograde Cholangiopancreatography Market

1. Ambu Inc.
2. Becton Dickinson And Company
3. Boston Scientific Corporation.
4. Conmed Corporation.
5. Cook Group Incorporation
6. Fujifilm Holdings Corporation.
7. Medtronic Plc
8. Olympus Corporation
9. Telemed System Inc.

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Recent Developments

• May 2025: Olympus demonstrates its AI-powered endoscopy solution (OLYSENSE) at DDW®, positioning it to enhance GI procedures, including ERCP, by supporting real-time decision-making during complex scopes.
• April 2025: Medtronic announces U.S. distribution agreement with Dragonfly™ Endoscopy, introducing technology aimed at improving pancreaticobiliary endoscopy (relevant to ERCP context).