Project description:Background and study aimEndoscopic retrograde cholangiopancreatography (ERCP) is generally performed via the major papilla when evaluating patients with pancreatic disease. However, in patients with pancreas divisum (PD) or distortion of the main pancreatic duct, endoscopic retrograde pancreatography (ERP) should be performed via the minor papilla (MP). Our aim was to evaluate the efficacy and safety of endoscopic pancreatic juice cytology (PJC), performed via the MP, in patients with PD.Patients and methodsPatients with PD who underwent diagnostic ERP via the MP, between January 2010 and February 2021, were identified retrospectively from our hospital's ERCP database. Twenty-two patients contributing to 24 ERCPs were included in the analysis.ResultsMP cannulation was successful in 23 of 24 ERCPs (96%). In one patient, successful cannulation was achieved on the second attempt and the procedure was performed twice in another. Serial pancreatic juice aspiration cytologic examination (SPACE) was performed in 17 patients, with a single aspiration of pancreatic juice performed in the other five. The sensitivity, specificity, and accuracy rates of ERCP diagnosis, overall, were 56%, 100%, and 80%, respectively. When diagnosis only based on SPACE was considered, the accuracy rate was even higher at 87%. Three patients (13%) developed mild pancreatitis as an adverse event.ConclusionsThe diagnostic ability of endoscopic PJC, via the MP in patients with PD was technically feasible and relatively effective under experienced pancreatobiliary endoscopists, however, requiring careful attention to post-ERCP pancreatitis when performed.

| S-EPMC8828241 | biostudies-literature

Pancreatoscopy-guided laser dissection of obstructing pancreatic duct stricture: pancreas-preserving endotherapy.

Project description:Video 1The case report is presented in the video, with a description of the patient's clinical course along with a set of endoscopic interventions including the use of per-oral pancreatoscopy with holmium laser therapy for stricturoplasty and stone fragmentation.

| S-EPMC9349054 | biostudies-literature

Clip-assisted minor pancreatic duct cannulation to manage pancreatic duct leak.

Project description: Not available

| S-EPMC6728872 | biostudies-literature

Digital per-oral cholangioscopy with holmium laser lithotripsy to manage complex biliary calculi.

Project description: Not available

| S-EPMC5990515 | biostudies-literature

Balloon overtube-assisted cholangioscopy and laser lithotripsy of large bile duct stones.

Project description: Not available

| S-EPMC6098815 | biostudies-literature

EUS-guided rendezvous technique for pancreas divisum.

Project description:Video 1EUS-guided rendezvous technique for pancreas divisum.

| S-EPMC10122073 | biostudies-literature

Digital pancreatoscopy with electrohydraulic lithotripsy to treat a pancreatic duct stone.

Project description: Not available

| S-EPMC5991816 | biostudies-literature

Pancreatic pseudocyst, pancreatitis, and incomplete pancreas divisum in a child treated with endotherapy: a case report.

Project description:Pancreatic divisum (PD) is caused by the lack of fusion of the pancreatic duct during the embryonic period. Considering the incidence rate of PD, clinicians lack an understanding of the disease, which is usually asymptomatic. Some patients with PD may experience recurrent pancreatitis and progress to chronic pancreatitis. Recently, a 13-year-old boy presented with pancreatic pseudocyst, recurrent pancreatitis, and incomplete PD, and we report this patient's clinical data regarding the diagnosis, medical imagining, and treatment. The patient had a history of recurrent pancreatitis and abdominal pain. Magnetic resonance cholangiopancreatography was chosen for diagnosis of PD, pancreatitis, and pancreatic pseudocyst, followed by endoscopic retrograde cholangiopancreatography, minor papillotomy, pancreatic pseudocyst drainage, and stent implantation. In the follow-up, the pseudocyst lesions were completely resolved, and no recurrent pancreatitis has been observed.

| S-EPMC8161893 | biostudies-literature

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