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Endoscopic approach through the minor papilla for the management of pancreatic diseases

World Journal of Gastrointestinal Endoscopy 2013年第3期5卷 81-88页

作者： Nao Fujimori Hisato Igarashi Akira Asou Ken Kawabe Lingaku Lee Takamasa Oono Taichi Nakamura Yusuke Niina Masayuki Hijioka Masahiko Uchida Kazuhiro Kotoh Kazuhiko Nakamura Tetsuhide Ito Ryoichi takayanagi Department of Medicine and Bioregulatory Science Graduate School of Medical SciencesKyushu UniversityHigashi-kuFukuoka 812-8582Japan Department of Gastroenterology National Hospital OrganizationKyushu Medical CenterChuou-kuFukuoka 810-8563Japan

AIM:To clarify the efficacy and safety of an endoscopic approach through the minor papilla for the management of pancreatic ***:This study included 44 endoscopic retrograde cholangiopancreatography(ERCP) procedures performed in 34 patients using a minor papilla approach between April 2007 and March *** retrospectively evaluated the clinical profiles of the patients,the endoscopic interventions,short-term outcomes,and ***:Of 44 ERCPs,26 were diagnostic ERCP,and 18 were therapeutic *** most common cause of difficult access to the main pancreatic duct through the major papilla was pancreas divisum followed by distortion of Wirsung's *** overall success rate of minor papilla cannulation was 80%(35/44),which was significantly improved by wire-guided cannulation(P = 0.04).Endoscopic minor papillotomy(EMP) was performed in 17 of 34 patients(50%) using a needle-knife(13/17) or a pull-type papillotome(4/17).EMP with pancreatic stent placement,which was the main therapeutic option for patients with chronic pancreatitis,recurrent acute pancreatitis,and pancreatic pseudocyst,resulted in short-term clinical improvement in 83% of *** post-ERCP pancreatitis occurred as an early complication in 2 cases(4.5%).CONCLUSION:The endoscopic minor papilla approach is technically feasible,safe,and effective when the procedure is performed in a high-volume referral center by experienced endoscopists.

关键词： Endoscopic papillotomy Endoscopic retrograde cholangiopancreatography Minor papilla Pancreas divisum Pancreatitis

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