title: Endoscopic minor papilla interventions in patients without pancreas divisum.
abstract: BACKGROUND
  Endoscopic treatment through the minor papilla is well known in patients with pancreas divisum. However, there are few data concerning endoscopic minor papilla interventions in patients without pancreas divisum when access to the main pancreatic duct via the major papilla is technically difficult.
  
  
  METHODS
  Records for 213 patients without pancreas divisum who, from April 2001 to June 2003, underwent ERCP for various pancreatic diseases were retrospectively reviewed. Patients were included if they had endoscopic interventions via the minor papilla because access through the major papilla was not possible.
  
  
  METHODS
  Minor papilla papillotomy or fistulotomy with endoscopic interventions was successful in 10 (91%) of 11 patients. Of these 10 patients, 9 had chronic pancreatitis and one had pancreatic ductal leak from previous pancreatic surgery. The reasons for the inability to access the main pancreatic duct to the tail of the gland via the major papilla included a distorted course of the main pancreatic duct (n=5), impacted stone (n=5), and stricture (n=8). In 8 patients, there were two causes. No complication related to the minor papilla interventions was observed in any patient.
  
  
  CONCLUSIONS
  Endoscopic minor papilla interventions are technically feasible in patients with pancreatic diseases but not pancreas divisum when access to the main pancreatic duct via the major papilla is not possible.
authors.affiliation: Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Moon Hee
authors.initials: MH
authors.lastname: Song
authors.forename: Myung-Hwan
authors.initials: MH
authors.lastname: Kim
authors.forename: Sung Koo
authors.initials: SK
authors.lastname: Lee
authors.forename: Sang Soo
authors.initials: SS
authors.lastname: Lee
authors.forename: Jimin
authors.initials: J
authors.lastname: Han
authors.forename: Dong Wan
authors.initials: DW
authors.lastname: Seo
authors.forename: Young Il
authors.initials: YI
authors.lastname: Min
authors.forename: Dong Ki
authors.initials: DK
authors.lastname: Lee
mesh_terms: D000328:Adult; D002404:Catheterization; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000002:abnormalities*; D010183:Pancreatic Ducts; D010195:Pancreatitis / Q000175:diagnosis / Q000601:surgery; D016717:Sphincterotomy, Endoscopic