Inclusion Criteria:

• Provision of signed and dated informed consent form

• Stated willingness to comply with all study procedures and availability for the duration of the study

• Male or female, aged ≥ 18

• Chronic pancreatitis as defined by  Cambridge grade 3 or 4 (3: > 3 abnormal side branches; abnormal main duct and branches) pancreatic ductal changes and/or parenchymal and/or intraductal calcifications (chronic calcific pancreatitis) by CT Scan or MRI/MRCP²⁴

• Minimally symptomatic:

  • Asymptomatic patients who were incidentally diagnosed with chronic pancreatitis based on imaging

  • Mild to moderate pain (visual analog scale ≤ 5) who do not require daily opioid pain medications

  • ≤ 1 episode of uncomplicated acute pancreatitis in 12 months prior to enrollment

Exclusion Criteria:

• History of diabetes (defined as either a HbA1c ≥ 6.5 % or a fasting glucose ≥ 126 mg/dL)

• Pancreatic duct obstruction limited to the tail of pancreas

• Surgically altered forgot anatomy prohibitive of ERCP with standard techniques (e.g Billroth II, Roux-en-y gastric bypass, pancreaticoduodenectomy)

• Prior pancreatic surgery

• Pancreatic head mass or suspicion for pancreatic malignancy

• Concurrent extra-pancreatic malignancy other than non-melanoma skin cancer

• Prior endoscopic therapy for pancreatic duct obstruction

• Acute pancreatitis < 90 days prior to enrollment

• Active alcohol use within 2 months of enrollment

• Gastrointestinal stricture/obstruction precluding passage of the duodenoscope to the papilla

• Standard contraindications to ERCP

• Unable to receive general anesthesia

• Age < 18 years, pregnancy, incarceration, unwillingness/inability to provide informed consent, or anticipated inability to follow protocol

Note: Other protocol defined Inclusion/Exclusion Criteria may apply.

Eligibility last updated 05/12/2026. Questions regarding updates should be directed to the study team contact.