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首页> 外文期刊>Digestive Diseases and Sciences >Endoscopic appearance of the minor papilla predicts findings at pancreatography.
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Endoscopic appearance of the minor papilla predicts findings at pancreatography.

机译：内窥镜检查发现小乳头可在胰腺造影时发现。

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BACKGROUND: The minor papilla serves as a site of alternative pancreatic duct drainage via the accessory pancreatic duct. AIMS: The objectives of this study were to assess the endoscopic appearance of the minor papilla for characteristics that might predict increased accessory pancreatic duct flow and hence suggest pathology of the downstream pancreatic ductal system. METHODS: This was a nonrandomized, prospective analysis of consecutively enrolled patients from a tertiary care medical center (Maine Medical Center, Portland, Maine). The study cohort consisted of consecutive patients presenting for endoscopic retrograde cholangiopancreatography (ERCP) without prior pancreaticobiliary endotherapy or ductography. RESULTS: Sixty-four patients received a minor papilla score prior to ERCP. A normal pancreatogram was found in 37 of 64 (57.8%) patients; the remaining 27 (42.2%) patients had an abnormal pancreatogram. The median minor papilla bulge score was 0.49 (range 0-3) in the normal pancreatogram group and 2 (range 0-3) in the abnormal pancreatogram group (P < 0.0001). The median minor papilla orifice score of those with a normal pancreatogram was 0 (range 0-2) compared to 2 (range 0-3) in the abnormal pancreatogram group (P < 0.001). The median minor papilla cumulative score of 1 (range 0-5) for the normal pancreatogram group was significantly less than that for the abnormal pancreatogram group (3, range 0-6, P < 0.0001), resulting in a sensitivity of 96.3% for an abnormal pancreatogram. The minor papilla orifice was noted to be either gaping or actively dripping pancreatic juice in four out of five patients with pancreas divisum. CONCLUSIONS: A minor papilla without bulging or a visible orifice would suggest a normal pancreatogram at ERP. Conversely, an abnormal minor papilla, particularly a patent minor papilla orifice, should raise suspicion of pancreatic ductal pathology and can help direct pancreatic endotherapy at the major or minor papillae.
机译：背景：小乳头通过替代胰管作为替代胰管引流的部位。目的：本研究的目的是评估镜下小乳头的内窥镜外观，以预测可能辅助胰管流量增加的特征，从而提示下游胰管系统的病理。方法：这是对来自三级医疗中心（缅因州波特兰市，缅因州医疗中心）的连续入组患者的非随机前瞻性分析。该研究队列包括连续接受内镜逆行胰胆管造影术（ERCP）且无事先胰胆管内镜治疗或影像学检查的患者。结果：64例患者在ERCP之前接受了轻度乳头评分。 64例患者中有37例（57.8％）的胰腺图正常;其余27名（42.2％）患者的胰腺造影异常。正常胰腺图组中位轻度乳头膨出评分为0.49（范围0-3），而异常胰腺图组中位数为2（范围0-3）（P <0.0001）。正常胰腺造影者的中位小乳头口分数为0（范围为0-2），而胰腺异常组为2（范围为0-3）（P <0.001）。正常胰腺造影组的小乳头中位累积分数为1（范围为0-5），显着低于异常胰腺造影组（3，范围为0-6，P <0.0001），结果敏感性为96.3％胰腺异常在五分之二的胰腺分裂症患者中，有四分之三的小乳头孔正在张开或正在主动滴入胰液。结论：小乳头没有鼓胀或可见的孔提示ERP时胰腺正常。相反，异常的小乳头，特别是小乳头小孔，应该引起胰腺导管病理学的怀疑，并可以帮助对大或小乳头进行胰腺内镜治疗。

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