Endoscopic retrograde cholangiopancreatography (ERCP) complications occur in 5 to 10% of cases, post ERCP pancreatitis is the most common, it is a complication with significant morbidity, occasional mortality and high costs. In the prevention of post-ERCP pancreatitis have been used various treatments, NSAIDs and pancreatic stent are the most useful, however, despite its use, post ERCP pancreatitis continues to affect 10 to 15% of patients with high risk. Epinephrine sprayed on the papilla may decrease the edema and prevent the development of this complication.