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University of Michigan Medical Center, Ann Arbor, MI, USA.
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Editor’s note: Acute pancreatitis is the most important and common complication following endoscopic retrograde cholangio-pancreatography (ERCP). In the past, multiple attempts have been made to reduce the incidence of this complication. However, neither mechanical intervention (with stents) nor pharmacological prophylaxis (with trasylol, somatostatin, or gabexate) have demonstrated consistent benefit. More recently, anti-inflammatory agents, including rectal and oral non-steroidal anti-inflammatory drugs (NSAIDs), have appeared to show considerable promise.