Tacrolimus as Prophylaxis of Post-ERCP Pancreatitis

The goal of this clinical trial is to learn if a single intravenous dose of tacrolimus,given before an ERCP procedure (an endoscopic procedure of the bile ducts and pancreas),can prevent post‐ERCP pancreatitis (PEP) in adults at moderate‐to‐high risk of developingthis complication.The main question it aims to answer is: ‐ Does a single dose of tacrolimus lower the number of participants who developpancreatitis after ERCP?Researchers will compare tacrolimus to a placebo (a look‐alike solution with no activedrug) to see if tacrolimus reduces the occurrence of PEP.Participants will: ‐ Receive an intravenous infusion of either tacrolimus or placebo, given over 60minutes, ending before the start of the ERCP procedure ‐ Receive standard preventive treatment (a rectal anti‐inflammatory medication(NSAID)) in addition to the study infusion ‐ Be contacted by phone 48 hours after the procedure to check for symptoms ‐ Complete questionnaires about quality of life and healthcare use, and be followedfor 12 weeks after the procedure ‐ The first 40 enrolled patients will have extra blood samples taken to measuretacrolimus levels.