The role of early endoscopic retrograde cholangiopancreatography (ERCP) and
sphincterotomy in acute pancreatitis is controversial. Recent randomised c
ontrolled trials mostly support the value of this procedure, but concerns r
emain as to its safety, efficacy and practicability. This debate critically
assesses the evidence for and against the use of early ERCP in acute pancr
eatitis.