Comparative Effectiveness Between Indomethacin and Pancreatic Stenting in the Prevention of Post ERCP Pancreatitis

This study compares two methods for preventing pancreatitis (inflammation of the pancreas) after a common stomach procedure called ERCP (endoscopic retrograde cholangiopancreatography). ERCP is used to examine the bile ducts and pancreas, but it can sometimes cause the pancreas to become inflamed. The two methods being compared are: a suppository medication called indomethacin (an anti-inflammatory drug) and a small plastic tube (pancreatic stent) placed temporarily in the pancreatic duct. Participants are patients who are already having ERCP and are considered at higher risk for post-procedure pancreatitis. The study aims to find which method better prevents this painful complication, helping doctors make evidence-based decisions during ERCP procedures. You may be eligible if: - You are 18 or older and scheduled for ERCP - You have at least one risk factor for post-ERCP pancreatitis (such as a history of it, difficult bile duct access, or certain anatomical features) You may NOT be eligible if: - You are pregnant or breastfeeding - You have a known allergy to NSAIDs (like ibuprofen or indomethacin) - You have active gastrointestinal bleeding - You have kidney failure (creatinine above 140) - You have heart failure - You have unusual digestive anatomy (other than certain types of previous stomach surgery) - You are under 18 years old Talk to your doctor to see if this trial is right for you.