Randomized Controlled Trial of Rectal Indomethacin Versus Combined Pancreatic Stent Placement and Rectal Indomethacin for Preventing Post-ERCP Pancreatitis

Inclusion Criteria: 1. Suspected sphincter of Oddi dysfunction 2. History of post ERCP Pancreatitis 3. Pancreatic instrumentation or sphincterotomy. 4. Precut sphincteroyomy 5. Difficult cannulation defined by more than 5 cannulation attempts 6. The use of double wire technique in bile duct access 7. At least 2 of the followings including 1. Female age \< 50 year 2. 3 pancreatogram 3. Acinarization (Contrast injection to tail of pancreas 4. Normal serum bilirubin 5. Guidewire to the tail of pancreas or secondary branches Exclusion Criteria: 1. Patient planned for pancreatic stenting 2. Without informed consent 3. Age \< 18 years 4. Pregnant women 5. Lactating women 6. Patient with altered anatomy 7. Contraindications to the use of NSAIDS 8. Renal failure 9. Ongoing or recent hospitalisation for acute pancreatitis 10. Allergy to aspirin or NSAIDs 11. known chronic calcific pancreatitis -