Postprocedure pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP) and is associated with a prolonged hospital stay and at times high morbidity and mortality.1 Extensive randomized clinical trials have evaluated systematically the potential risk reduction of post-ERCP pancreatitis by pharmacologic prophylaxis with indomethacin.2 Recent major clinical evidence generally supports the use of rectal administration of indomethacin for post-ERCP prophylaxis.