Endoscopic-retrogradecholangiopancreatography (ERCP) currently has a pivotal importance in management of a wide variety of hepato-pancreatico-biliary disorders. It is a major endoscopic technique that requires not only high volume centres but also highly qualified endoscopic teams. Patients with liver cirrhosis are at increased risk for complications after surgery and probably also after the major endoscopic techniques including the ERCP. That is why the paper published by El-Naggar et al., 2013 in the Afro-Egyptian Journal of Infectious and Endemic Diseases seems interesting; the authors performed several invasive procedures in patients with Child A and B liver cirrhosis and the outcomes were unexpectedly excellent.