Reappraisal of factors impacting the cannulation rate and clinical efficacy of endoscopic minor papilla sphincterotomy

Bellocchi, Maria Cristina Conti; Crinò, Stefano Francesco; Pin, Federico; Stefano, Serena Di; Grazie, Marco Le; Bernardoni, Laura; Ruffini, Martina; Frulloni, Luca; Gabbrielli, Armando

doi:10.1016/j.pan.2021.01.019

Cited by 2 publications

(3 citation statements)

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“…Conti et al reported that the technical success rate of the minor papilla cannulation was 82.1%. 5 The reasons for the difficulty of the minor papilla cannulation are the inability to identify the minor papilla and the absence of a visible orifice. 1 Several studies have described the methods for the detection of minor papillary orifices.…”

Section: Discussionmentioning

confidence: 99%

“…The effectiveness of TXI has been frequently reported in detecting and visualizing gastrointestinal diseases. 8 In the context of pancreatobiliary lesions, TXI has proven to be a valuable tool in identifying anastomotic strictures and bile duct orifices, [2][3][4][5][6][7][8][9] as well as in enhancing the diagnostic quality of peroral cholangioscopy. 10 However, there is currently no published evidence of its usefulness in identifying the orifice of the minor papilla.…”

Section: Discussionmentioning

confidence: 99%

“…Dorsal pancreatic duct cannulation of the minor papilla is a challenging procedure. Conti et al reported that the technical success rate of the minor papilla cannulation was 82.1% 5 . The reasons for the difficulty of the minor papilla cannulation are the inability to identify the minor papilla and the absence of a visible orifice 1 .…”

Section: Discussionmentioning

confidence: 99%

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The usefulness of texture and color enhancement imaging to identify the minor papilla orifice

Goda,

Irie,

Anan

et al. 2024

DEN Open

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In clinical cases of pancreas divisum, endoscopic retrograde cholangiopancreatography often necessitates cannulation of the pancreatic duct through the minor papilla. Nevertheless, this procedure can be challenging because of the small size of the minor papilla and the difficulty in visualizing the ductal orifice. A new image‐enhanced endoscopy technique called texture and color enhancement imaging (TXI) has been developed, which enhances texture, brightness, and color compared with white‐light imaging, resulting in subtle differences in the surface mucosa. Herein, we describe the case of a 73‐year‐old man with pancreas divisum in whom TXI was useful in identifying the orifice of the minor papilla. He was referred to our hospital with repetitive acute exacerbation of chronic pancreatitis. Since contrast‐enhanced computed tomography revealed a pancreatic stone in the main pancreatic duct, endoscopic retrograde cholangoepancreatography was performed as a therapeutic intervention. Despite the initial difficulty in identifying the orifice of the minor papilla on white‐light imaging, TXI enhanced its visibility successfully, enabling dorsal pancreatic duct cannulation via the minor papilla. Subsequently, endoscopic pancreatic sphincterotomy was performed and a 6Fr plastic stent was placed. Post‐endoscopic therapy, the patient's abdominal pain was relieved. TXI was useful in identifying the minor papilla orifice and led to successful cannulation.

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Section: Discussionmentioning

confidence: 99%