We have read with great interest the article of Levenick et al. in the recent issue of Gastroenterology on the effect of rectal indomethacin for the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP).1 The authors are to be congratulated on a very relevant placebo-controlled, prospective, randomized, double-blind study to evaluate the efficacy of rectal indomethacin in preventing PEP in patients with average risk.1 This type of trial is very important for endoscopists performing ERCP to draw correct conclusions in everyday situations.