Objective:To evaluate the efficacy and safety of ERCP in minimally invasive treatment of biliary and pancreatic diseases.Methods:Clinical data of 177 patients with biliary and pancreatic diseases treated with ERCP in Qianjiang Central Hospital from January 2020 to March 2022 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 75 patients were male and 102 female, aged (62±13) years on average. 151 patients were diagnosed with bile duct stones, 15 cases of malignant biliary obstruction,5 cases of benign obstruction, 4 cases of bile leakage and 2 cases of pancreatic duct stones. Clinical efficacy and the incidence of postoperative complications of ERCP for biliary and pancreatic diseases were observed.Results:The success rate of ERCP was 98.3%(174/177). The incidence of postoperative complications was 3.4%(6/177), including 3 cases of postoperative acute pancreatitis, 2 cases of duodenal papilla hemorrhage and 1 case of intestinal perforation, who died after operation. Among 151 patients with choledocholithiasis, 131 cases underwent EPBD and 20 cases received endoscopic sphincterotomy (EST). The stone clearance rate was 97.3%(147/151). Among 15 cases of malignant biliary obstruction, ERCP was not successfully performed in 1 case who was converted to PTCD for reduction of jaundice. 2 cases with malignant tumors underwent radical pancreaticoduodenectomy following pathological biopsy under ERCP and endoscopic nasobiliary drainage jaundice reduction. The remaining 12 cases were treated with biliary stent implantation. In 5 cases with benign biliary obstruction were successfully treated with ERCP balloon dilatation and biliary stent drainage. 4 cases with bile leakage were cured by conservative treatments after ERCP drainage. Pancreatic duct stones in 2 cases were removed by ERCP and pancreatic duct stents were implanted, and the patients' abdominal pain was significantly relieved.Conclusions:ERCP is a safe and efficacious treatment for biliary and pancreatic diseases. Standardized procedures and attentive perioperative management can minimize the risk of postoperative complications.