Endoscopic cannulation of the papilla of Vater was first reported in 1968 [1]. However, it was really put on the map shortly afterwards by several Japanese groups, working with instrument manufacturers to develop appropriate long side-viewing instruments [2][3][4][5]. The technique (initially called ECPGa endoscopic cholangiopancreatographyain Japan) spread throughout Europe in the early 1970s [6][7][8][9][10][11][12][13]. Early efforts were much helped by a multinational workshop at the European Congress in Paris in 1972, organized by the Olympus company. ERCP rapidly became established worldwide as a valuable diagnostic technique, although doubts were expressed in the USA about its feasibility and role [14], and the potential for serious complications soon became clear [15][16][17][18]. ERCP was given a tremendous boost by the development of its therapeutic applications, notably biliary sphincterotomy in the mid-1970s [19-21] and biliary stenting 5 years later [22,23].It is difficult for most gastroenterologists today to imagine the diagnostic and therapeutic situation 30 years ago. There were no scans. Biliary obstruction was diagnosed and treated surgically, with substantial operative mortality. Nonoperative documentation of biliary pathology by ERCP was a huge step forward. Likewise, ERCP was an amazing development in pancreatic investigation at a time when the only available test was laparotomy. The ability to 'see into' the pancreas, and to collect pure pancreatic juice [24], seemed like a miracle. We assumed that ERCP would have a dramatic impact on chronic pancreatitis and pancreatic cancer. Sadly, these expectations are not yet realized, but endoscopic management of biliary obstruction was clearly a major clinical advance, especially in the sick and elderly. The period of 15 or so years from the mid-1970s really constituted a 'golden age' for ERCP. Despite significant risks [25], it was obvious to everyone that ERCP management of duct stones and tumors was easier, cheaper, and safer than available surgical alternatives. Large series were published, including some randomized trials [26][27][28][29][30][31]. Percutaneous transhepatic cholangiography (PTC) and its drainage applications were also developed 1 Advanced Digestive Endoscopy: ERCP Edited by Peter B. Cotton, Joseph Leung