Even in 2016, with all of our accumulated knowledge about pancreaticobiliary interventions, minimally traumatic cannulation techniques, the role and value of pancreatic duct stents, and the need for adequate training in the performance of endoscopic retrograde cholangiopancreatography (ERCP), post-ERCP pancreatitis (PEP) remains the single most common (and dreaded) complication of the procedure.1–4 PEP still results in significant morbidity among patients undergoing ERCP and is still a cause of occasional mortality, usually in patients who develop severe or necrotizing pancreatitis.