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In the year before the first lunar landing, it is now almost 60 years since Drs McCune, Shorb and Moscovitz performed the first ERCP using an Eder fibreoptic duodenoscope at Georgetown University. Rapid progress in endoscope and accessory technology expanded ERCP endoscopy to diagnose and treat biliary stones, cholangitis and benign or malignant strictures. Expansion in imaging using ultrasound, CT or MRI and endoscopic ultrasound (EUS) has led to ERCP being an almost exclusively therapeutic procedure.