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• W1997004802 abstract "Background and Aim: Minor papilla cannulation and sphincterotomy is usually required for patients with pancreas divisum and chronic pancreatitis. Moreover, it can be useful in patients with fused ducts and a difficult access to the main pancreatic duct (MPD) via the major papilla. Direct cannulation of the minor papilla is a challenging procedure also for expert endoscopists. Major-minor papilla pancreatic rendez-vous (PRV) can allow an easier access to the minor papilla. Aim of the study is to evaluate technical results of PRV in a large retrospective series of patients. Patients and Methods: From 1994 to May 2007, PRV was attempted by expert endoscopists in 36 patients with chronic pancreatitis (23 males, median age 44 years, range 11-79) due to a difficult access to the MPD through the major papilla. PRV was performed as follows: a dorsal and ventral duct connection was identified at pancreatography from the major papilla; an angled-tip hydrophilic guidewire (0.035”/0.018”), inserted form the major papilla, was manoeuvred to pass through the accessory duct and minor papilla into the duodenum; the tip of the wire was grasped with a foreign-body forceps and retracted from the accessory channel; minor papilla was cannulated over-the-wire. Other operative procedures were performed as clinically requested. Results: Indications to drain the MPD through the minor papilla were: incomplete pancreas divisum (n = 18); easier access to the MPD through the minor papilla due to a tortuous ventral duct (ansa pancreatica and “H-configuration”) (n = 9); normal anatomy with strictures or stones hindering drainage from the major papilla (n = 9). The PRV was successfully performed in 32 (89%) patients; in 4 cases (13%) only after a second attempt. No specific complications after PRV occurred. PRV failed in 4 patients. Direct minor papilla cannulation was unsuccessfully attempted in all 4 patients. Minor papilla precut was performed in 2 of these patients. MPD drainage was achieved only in 1 case. In the other 3 patients MPD drainage was completed from the major papilla after several attempts. Conclusions: The PRV is a feasible, reliable and safe procedure. It can allow a quick cannulation of the minor papilla when the drainage of the MPD through the major papilla is difficult. The PRV can theoretically reduce the risk of complications due to traumatic manoeuvres on the minor papilla or precut." @default.
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• W1997004802 date "2008-04-01" @default.
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• W1997004802 title "Easy Access to the Pancreatic Duct Via the Minor Papilla: The Pancreatic Rendez-Vous Technique" @default.
• W1997004802 doi "https://doi.org/10.1016/j.gie.2008.03.986" @default.
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