Abstract Purpose. Clinical rationale pancreatic stenting in prevention and treatment of post endoscopic retrograde cholangiopancreatography pancreatitis (PEP). Material and methods. In the Railway Clinical Hospital at Samara Station 640 transpapillar invasive procedures were performed during the period of 2015—2018. PEP was diagnosed in 26 (4.06%) cases. During the period of 2015—2016 (the first group) major pancreatic duct stentings were not implemented yet, but 211 ERCP procedures were performed; acute pancreatitis was diagnosed in 19 (9%) cases. During the period from 2017 till 2018 — 429 procedures were performed; acute pancreatitis was diagnosed in 7 (1.6%) cases. It’s important that during this period the preventive main pancreatic duct (MPD) stenting were performed. Based on the first group patient’s analysis the following PEP risk factors were identified: female sex, young age, litoextraction with choledocholithiasis, uneven cannulation of MPD, non-selective EPT. Results. In all the patients with one or several PEP risk factors we have undertaken the attempt to perform preventive MPD stenting by 5Fr stents. The stenting was successful in 54 out of 71 cases. Technical success was 76%. Among the patients with preventive MPD stenting no cases of acute PEP were observed. Among the patients with PEP risk factors, in whom the preventive MPD stenting procedure was not technically successful, acute pancreatitis developed in 7 (1.6%) cases. In 5 cases the complication was stopped by MPD stenting within first 24 hours. Conclusion. Identification of the PEP risk factors in patients who have to undergo endoscopic transpapillar procedures is the indication for the major pancreatic duct preventive stenting. Application of MPD stenting decreased the acute pancreatitis risk from 9% to 1.6%. MPD stenting during first hours of PEP onset may abort its development.