Pancreatic Endotherapy for Refractory Chronic Pancreatitis

Inclusion Criteria * Age ≥ 18 years * Main pancreatic duct obstruction, defined by the presence of one or both of the following features: * Main pancreatic duct calcification with upstream main duct dilation ≥6mm. * Main pancreatic duct stricture, defined by the presence of main pancreatic duct narrowing with upstream main duct dilation ≥6mm. * Baseline average abdominal pain score ≥4 during the run-in period, based on Ecological Momentary Assessment 11-point Numeric Rating Scale * Ability to provide written, informed consent Exclusion Criteria * Symptoms attributable to a pancreatic pseudocyst or walled off necrosis * Clinical suspicion of pancreatobiliary malignancy\* * Low probability of follow-up to complete study objectives * Pregnancy or incarceration * Medical comorbidities that contraindicate the performance of ERCP * Previous pancreatic endotherapy * Current Opioid Misuse Measure score ≥9 * Does not have access to a mobile phone \* Pancreatobiliary malignancy