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Gastrointestinal and Pancreatico-Biliary Diseases: Advanced Diagnostic and Therapeutic Endoscopy pp 1167–1186Cite as

Minor Papilla Cannulation and Papillotomy

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Abstract

Pancreas divisum is the most frequently encountered, congenital variant of pancreas duct anatomy. Associations between pancreas divisum, recurrent acute pancreatitis, and chronic pancreatitis are well described in the literature. Endotherapy directed at the minor papilla in the form of minor papillotomy and dorsal pancreatic duct stent placement have favorable outcomes in patients with recurrent acute pancreatitis in the setting of pancreas divisum. Dorsal duct endotherapy can also be performed via the minor papilla in the setting of painful chronic pancreatitis to manage discrete pathologic findings such as pancreatic stones and/or dorsal pancreatic duct strictures. Post-ERCP pancreatitis is the most frequent complication of these techniques and the risk escalates based on the maneuvers performed during a procedure. We describe the optimal techniques for locating the minor papilla, dorsal duct cannulation, minor papillotomy, and dorsal duct endotherapy.

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Author information

Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA

    Jeffrey J. Easler, Evan Fogel & Stuart Sherman

Authors
  1. Jeffrey J. Easler
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  2. Evan Fogel
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  3. Stuart Sherman
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Corresponding author

Correspondence to Jeffrey J. Easler .

Editor information

Editors and Affiliations

  1. Division of Gastroenterology and Gastrointestinal Endoscopy IRCCS, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy

    Pier Alberto Testoni

  2. Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan

    Haruhiro Inoue

  3. Department of Gastroenterology and Hepatology, Mayo Clinic Florida, Jacksonville, FL, USA

    Michael B. Wallace

Section Editor information

  1. Gastrointestinal Endoscopy Unit, Vita‐Salute San Raffaele University, Milan, Italy

    Pier Alberto Testoni

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Easler, J.J., Fogel, E., Sherman, S. (2022). Minor Papilla Cannulation and Papillotomy. In: Testoni, P.A., Inoue, H., Wallace, M.B. (eds) Gastrointestinal and Pancreatico-Biliary Diseases: Advanced Diagnostic and Therapeutic Endoscopy. Springer, Cham. https://doi.org/10.1007/978-3-030-56993-8_67

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  • DOI: https://doi.org/10.1007/978-3-030-56993-8_67

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-56992-1

  • Online ISBN: 978-3-030-56993-8

  • eBook Packages: MedicineReference Module Medicine

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