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Endoscopic retrograde cholangiography (ERCP) usually involves

1. Cannulation of the hepatopancreatic ampulla
2. Introduction of contrast medium into the common bile duct
3. Introduction of barium directly into the duodenum

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Final answer:

Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure involving endoscopic cannulation of the hepatopancreatic ampulla, contrast medium injection into the bile and pancreatic ducts, and X-ray imaging to diagnose and treat biliary and pancreatic duct conditions.

Step-by-step explanation:

Endoscopic retrograde cholangiopancreatography (ERCP) is a medical procedure used to diagnose and treat conditions related to the biliary tree and pancreas. The procedure typically involves the insertion of an endoscope through the mouth, down the throat, and into the stomach and small intestine. Once the endoscope reaches the small intestine, the hepatopancreatic ampulla, or ampulla of Vater, is located and cannulated. This allows for the introduction of a contrast medium into the common bile duct and pancreatic duct, which enables the visualization of these structures on an X-ray. The procedure aids in identifying any obstructions or issues within the bile and pancreatic ducts.

The hepatopancreatic ampulla is where the main pancreatic duct and the bile duct join and open into the duodenum. It is regulated by the hepatopancreatic sphincter, also known as the sphincter of Oddi. Through ERCP, visualization and interventions are possible to relieve blockages, obtain tissue samples, and treat conditions that may affect the gallbladder, liver, pancreas, and other related structures.