_{Biodegradable stent (BDS) represents a promising alternative to conventional plastic stents in Endoscopic Retrograde Cholangiopancreatography (ERCP) that may reduce repeat procedure, cost, and environmental impact. This study evaluated technical success, clinical outcomes, cost, and carbon footprint associated with BDS use across biliary and pancreatic indications in a real world, single center setting.}

_{We conducted a 5-year retrospective review of ERCPs with BDS from October 2020 to October 2025, evaluating indications, procedural success, and clinical outcomes along with cost and estimated carbon footprint (5 kgCO₂e/procedure).}

_{In 152 patients (biliary 78, pancreatic 74) biodegradable stent placement achieved 100% (152/152) technical success with full fluoroscopic visibility. For biliary cases, the primary indication was post-cholecystectomy bile leak (57/78,73%) with 96.5% (55/57) resolution. Minor indications included bridge to cholecystectomy (10/78), CBD strictures (4/78), edematous ampulla (1/78), gallbladder perforation (1/78), and unexplained biliary dilatation (1/78), all achieving 100% clinical success, with cholangitis prevention in 75% (3/4) of cases.}

_{Pancreatic intervention was mainly for post ERCP pancreatitis prophylaxis (71/74; 96%) with (55/71; 77.5%) success rate, and 2.8% (2/71) mortality due to severe pancreatitis.Rare cases of duct dysfunction (2/2) and stricture (1/1) achieved 100% success.} 

_{Total cost savings were estimated at £101,021 by avoiding 74 abdominal X-rays, some of which may have required an OGD, and 78 ERCPs for stent removal, resulting in an estimated carbon footprint reduction of 649 kg CO₂e.}

_{Biodegradable biliary and pancreatic stents deliver a safe and effective ERCP with excellent outcomes, lower healthcare cost and offers a truly patient centred and environmentally sustainable approach.}