Background Pancreatitis is the most feared complication of endoscopic papillectomy (EP). Prevention by pancreatic duct stenting following EP has been advocated but not proven by a randomized trial. The purpose of the present retrospective review is to compare a period of systematic stenting with the period before in which stents were placed selectively. Methods A total of 107 patients undergoing EP from February 1999 to December 2009 were retrospectively reviewed. After an initial period with selective stenting (dilated duct, previous pancreatitis) between 1999 and 2002 ( n  = 24, group 1), stents were placed routinely after EP unless pancreas divisum was diagnosed (2002–2009; n  = 83, group 2) to reduce postpapillectomy acute pancreatitis (PAP). PAP rates defined by Consensus Criteria were compared in the two periods. Results Five patients in group 1 were selected to receive a pancreatic stent (21 %); in group 2 stenting was successful in 75 of 78 patients (success rate 96 %) without pancreas divisum ( n  = 5). Overall, PAP occurred in 11 % of patients. PAP rate was significantly reduced after introduction of systematic pancreatic stenting (5 vs 25 %; p  = 0.01) and occurred less often in stented than in nonstented patients: (5 % (4/80) vs 27 % (6/22), p  = 0.0019). PAP also occurred in one of five patients with pancreas divisum. Selective stenting of patients also was an independent risk factor for PAP (OR 13, p  = 0.001) in a multivariate analysis. Conclusions Attempts at systematic stenting after EP pancreatic stenting appears to prevent PAP. Results should be corroborated by a randomized trial.