Study of patency of minor duodenal papilla

Comparison between pigment method combined with pH sensor and pancreatographic method

Abstract

We investigated the patency of minor duodenal papilla in 25 cases that had presented normal pancreatogram by using the endoscopic retrograde pancreatographic (ERP) method and a pH sensorcombined indigo carmine pigment method. The pigment method allowed us to classify the function of minor papilla into three types according to pancreatic juice excretion pre- and post-secretin administration (Type I), excretion after secretin administration (Type II), and no excretion even after secretin administration (Type III). Twelve cases belonged to Type I, 4 cases to Type II and 9 cases to Type III. By ERP method, terminal shapes of the Santorini's duct were classified as stick type, cystic type and branch type. 19 cases were considered stick type, 2 cases cystic type and 4 cases branch type. Eighteen cases were identified as patent minor papilla under ERP method. There were two cases alleged to be patent under the ERP but without pancreatic juice excretion. Therefore, the necessity of pigment method was confirmed for investigation of the function of minor papilla.