Physician-controlled wire-guided cannulation of the minor papilla.
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.
Maple
John T
JT
Division of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, 920 Stanton L. Young Boulevard, WP 1345, Oklahoma City, Oklahoma 73117, USA.
Mansour
Lilah
L
Ammar
Tarek
T
Ansstas
Michael
M
Coté
Gregory A
GA
Azar
Riad R
RR
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