Intraductal Secretin Stimulation Test: What Is the Proper Collection Time?

Inclusion Criteria: 1\. Male or female patients ≥ 18 years of age referred to Indiana University Health, University Hospital for ERCP for a biliary indication, at the discretion of the treating MD (e.g. suspected common bile duct stone, initial post-liver transplant evaluation, suspected or confirmed cholangiocarcinoma, suspected primary sclerosing cholangitis -- see exclusion criterion #12) Exclusion Criteria: 1. Pregnant woman or breast feeding 2. Age \<18 years 3. Patient unable to give informed consent 4. Patient with a history of pancreatic surgery 5. Patient with a history of pancreatic cancer 6. Patient with a history of acute or chronic pancreatitis 7. Patient with radiographic evidence of acute or chronic pancreatitis on CT, MRCP, or EUS 8. Patient with a current or prior history of average daily alcohol consumption of greater than 60 g per day for more than 2 years 9. Patient with a history of cigarette smoking greater that 20 pack-years 10. Patient with a history of pancreas divisum 11. Evidence of chronic pancreatitis on pancreatogram during ERCP 12. ERCP for an isolated biliary indication with previous biliary sphincterotomy or for biliary stent exchange, when pancreatic entry should easily be avoided by the endoscopist. 13. History of allergy or adverse reactions to secretin