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Pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP) and occurs in 20% to 30% of high-risk patients. Several animal studies have suggested that allopurinol, a xanthine oxidase inhibitor and an effective antioxidant with antiapoptotic effects, might prevent oxidative insult that triggers post-ERCP pancreatitis (PEP). However, two previously published studies in humans failed to show any benefit for allopurinol, whereas a third did show a significant reduction (JW Gastroenterol Jul 26 2005 and Gastrointest Endosc 2005; 62:245). Based on compelling animal data but inconsistent results from prior randomized trials in humans, researchers based in Canada have conducted a fourth trial to examine all…