Transforming endoscopic retrograde cholangiopancreatography: the role of artificial intelligence in pre-operative planning, intraoperative navigation, and post-operative risk prediction

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a technically demanding procedure for pancreaticobiliary diseases. Artificial intelligence (AI) is transforming ERCP by improving diagnostic accuracy, procedural safety, and postoperative risk prediction. This review synthesizes AI applications across the entire workflow: preoperative planning using multimodal risk models, intraoperative navigation via real-time anatomical localization and augmented reality, and postoperative complication prediction with dynamic algorithms. AI also optimizes anesthesia and ambulatory surgery workflows. Challenges remain in data standardization, legal accountability, and clinical integration. We advocate for multicenter collaboration, ethical oversight, and comprehensive patient management systems to establish AI-assisted ERCP as a new standard for personalized interventional care.