This study is designed to learn whether rinsing the papilla with cold water at the end of an ERCP procedure, in addition to standard medicine, can help lower the chance of developing pancreatitis, which is the most common major complication after ERCP.
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Eligibility Criteria
Inclusion Criteria:
* Native papilla present.
* Undergoing ERCP for diagnostic or therapeutic indications.
* Able to provide informed consent.
Exclusion Criteria:
* Post-operative reconstructed intestinal tract other than Billroth I reconstruction.
* Acute pancreatitis at the time of ERCP.
* Chro…
Inclusion Criteria:
* Native papilla present.
* Undergoing ERCP for diagnostic or therapeutic indications.
* Able to provide informed consent.
Exclusion Criteria:
* Post-operative reconstructed intestinal tract other than Billroth I reconstruction.
* Acute pancreatitis at the time of ERCP.
* Chronic pancreatitis.
* Pancreatic head cancer with occlusion of the main pancreatic duct.
* Existing pancreatic duct stent or need for prophylactic pancreatic duct stenting during the index ERCP.
* Known contraindications or allergy to indomethacin or other NSAIDs.
* Significant renal impairment (eGFR \< 30 mL/min/1.73m²).
* Active peptic ulcer disease or history of NSAID-induced gastrointestinal bleeding.
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