Cold Water Irrigation Therapy as an Adjunct to Indomethacin for Post-Endoscopic Retrograde Cholangiopancreatography(ERCP) Pancreatitis

Inclusion Criteria: * Native papilla present. * Undergoing ERCP for diagnostic or therapeutic indications. * Able to provide informed consent. Exclusion Criteria: * Post-operative reconstructed intestinal tract other than Billroth I reconstruction. * Acute pancreatitis at the time of ERCP. * Chronic pancreatitis. * Pancreatic head cancer with occlusion of the main pancreatic duct. * Existing pancreatic duct stent or need for prophylactic pancreatic duct stenting during the index ERCP. * Known contraindications or allergy to indomethacin or other NSAIDs. * Significant renal impairment (eGFR \< 30 mL/min/1.73m²). * Active peptic ulcer disease or history of NSAID-induced gastrointestinal bleeding.