One Case of Endoscopic Stenting with Minor Papilla Sphincterotomy in a Patient with Chronic Pancreatitis.
- Author:
Chan Sup SHIM
1
;
Joon Seong LEE
;
Moon Sung LEE
;
Joo Young CHO
;
Young Deok CHO
;
Jong Ho MOON
;
Yun Soo KIM
;
In Seop JUNG
Author Information
1. Institute for Digestive Research, Department of Internal Medicine, Soon Chun Hyang University College of Medicine, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Chronic pancreatitis;
Minor papilla;
Endoscopic sphincterotomy;
Endosco-pic pancreatic drainage
- MeSH:
Abdominal Pain;
Adult;
Drainage;
Follow-Up Studies;
Humans;
Pancreatic Ducts;
Pancreatic Juice;
Pancreatitis;
Pancreatitis, Chronic*;
Sphincterotomy, Endoscopic;
Stents*
- From:Korean Journal of Gastrointestinal Endoscopy
1999;19(3):491-496
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The anatomy of the pancreatic ducts and their variations are best defined through a pancreatography, which is especially useful for determining the appropriate endoscopic management. Pressure in the pancreatic ductal system has been shown to be significantly higher in patients with painful chronic pancreatitis and dilated ducts when compared with pressure in controls. The aim of pancreatic drainage procedures is to improve the outflow of pancreatic juice, thereby lowering intraductal pressure and affording relief of pain. It is necessory for both endoscopic pancreatic sphincterotomy (EPS) and stenting have to be performed at the papilla of the dominant duct, which is the Wirsung duct (embryologic "ventral" duct), in the majority such of cases. An EPS of the minor papilla should be considered when the duct of Santorini (embryologic "dorsal" duct) predominates, as in patients with complete or incomplete divided ducts or with a distorted connection between the ventral and the dorsal duct. In these patients, access to the main pancreatic duct (MPD) is easier through the duct of Santorini. A 42 year-old man was admitted with chronic recurrent pancreatitis. Minor papilla sphincterotomy and endoscopic stent placement were performed for the drainage of the dorsal pancreatic duct. After stenting of the minor papilla, abdominal pain disappeared and pancreatitis did not develop after a 7 month follow-up, the stent was changed.
