title: Physician-controlled wire-guided cannulation of the minor papilla.
abstract: Background. Minor papilla (MiP) cannulation is frequently performed using specialized small-caliber accessories. Outcomes data for MiP cannulation with standard-sized accessories are lacking. Methods. This is a case series describing MiP cannulation outcomes in consecutive patients treated by two endoscopists between July 2005 and November 2008 at two tertiary referral centers. MiP cannulation was attempted using a 4.4 Fr tip sphincterotome loaded with a 0.035(″), 260 cm hydrophilic-tip guidewire, using a wire-guided technique under physician control. Results. 25 patients were identified (14 women, mean age 45). Procedure indications included recurrent acute pancreatitis in 16 patients (64%) and chronic pancreatitis in 2 (8%), among other indications. MiP cannulation was successful in 24 patients (96%). Sphincterotomy followed by pancreatic stent placement was performed in 21 patients (84%). Mild post-ERCP pancreatitis occurred in 3 patients (12%). Conclusion. Physician-controlled wire-guided MiP cannulation using a 4.4 Fr sphincterotome and 0.035(″) guidewire is an effective and safe technique.
authors.affiliation: Division of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, 920 Stanton L. Young Boulevard, WP 1345, Oklahoma City, Oklahoma 73117, USA.
authors.forename: John T
authors.initials: JT
authors.lastname: Maple
authors.forename: Lilah
authors.initials: L
authors.lastname: Mansour
authors.forename: Tarek
authors.initials: T
authors.lastname: Ammar
authors.forename: Michael
authors.initials: M
authors.lastname: Ansstas
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Coté
authors.forename: Riad R
authors.initials: RR
authors.lastname: Azar
references.citation: Gastrointest Endosc. 2008 Oct;68(4):667-73
references.pmid: 18436218
references.citation: Am J Gastroenterol. 2009 Sep;104(9):2343-50
references.pmid: 19532133
references.citation: Gastrointest Endosc. 1990 Nov-Dec;36(6):553-7
references.pmid: 2279641
references.citation: Gastrointest Endosc. 2009 Jan;69(1):47-54
references.pmid: 18656861
references.citation: Gastrointest Endosc. 1993 Jan-Feb;39(1):1-8
references.pmid: 8454127
references.citation: Gastrointest Endosc. 2002 Mar;55(3):376-81
references.pmid: 11868012
references.citation: Dig Dis Sci. 1995 Sep;40(9):1974-81
references.pmid: 7555452
references.citation: Gastrointest Endosc. 2006 Nov;64(5):705-11
references.pmid: 17055861
references.citation: Gastrointest Endosc. 2009 Mar;69(3 Pt 1):444-9
references.pmid: 19007927
references.citation: Gastrointest Endosc. 1992 Jul-Aug;38(4):430-4
references.pmid: 1511816