Physician-Controlled Wire-Guided Cannulation of the Minor Papilla

Abstract EN

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.