Despite the careful observance of standard precautions during endoscopic sphincterotomy (ES) [in human patients], serious complications are sometimes unavoidable and these may require various forms of treatment. Surgical intervention is necessary for fulminating pancreatitis, acute arterial hemorrhage and retroperitoneal abscess. The endoscopic insertion of a drainage tube into the common bile duct can serve to overcome biliary obstruction due to cholangitis secondary to stone impaction, Dormia basket impaction or blood clot. The obstruction can be removed electively endoscopically or surgically in a symptom-free interval. Uncomplicated perforation can be treated by parenteral feeding and nasogastric suction. Acute pancreatitis may require further intensive case procedures such as peritoneal or hemodialysis and early intermittent positive pressure respiration. Using these methods, the mortality rate due to ES is reduced to 0.5%.