Endoscopic treatment of pancreatic diseases via Duodenal Minor Papilla: 135 cases treated by Sphyncterotomy, Endoscopic Pancreatic Duct Balloon Dilation (EPDBD), and Pancreatic Stenting (EPS)

Abstract

Treatments via the minor papilla is effective where the deep cannulation via the major papilla is impossible in such cases as [1] the Wirsung’s duct is infl ammatory narrowed, bent or obstructed by impacted stones [2] pancreatic duct divisum (complete or incomplete) [3], maljunction of pancreatico-biliary union with stones [4], pancreatic stones in the Santorini’s duct. In [1,2] cases, the pancreatic juice fl ow via the major papilla decreases, while that of the minor papilla increases. Then the size of minor papilla and its orifi ce shows corresponding enlargement. This substitutional mechanism is an advantage when undertaking our new method. Since the pancreatic juice fl ow is maintained via the minor papilla in these cases, accurate and careful endoscopic skills are necessary to prevent pancreatitis due to the occlusion of the Santorini’s duct after this procedure. We have experienced 135 cases treated via minor papilla in these 27 years, so we would like to report about its safety and effi cacy. More Information Submitted: 20 June 2019 Approved: 05 July 2019 Published: 08 July 2019 How to cite this article: Tsuji T, Sun G, Sugiyama A, Amano Y, Mano S, et al. Endoscopic treatment of pancreatic diseases via Duodenal Minor Papilla: 135 cases treated by Sphincterotomy, Endoscopic Pancreatic Duct Balloon Dilation (EPDBD), and Pancreatic Stenting (EPS). Ann Clin Gastroenterol Hepatol. 2019; 3: 012-019. https://doi.org.10.29328/journal.acgh.1001009 Copyright: © 2019 Tsuji T, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited