Physician-controlled wire-guided cannulation of the minor papilla

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 4.4Fr tip sphincterotome loaded with a 0.03 5 , 260cm 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 4.4Fr sphincterotome and 0.03 5 guidewire is an effective and safe technique.