Abstract
Most efforts to perform pancreatography for assessment of leaks, constriction, filling defects, or irregularity due to chronic pancreatitis are pursued through the major papilla at the ampullary junction with the bile duct. Endoscopic cannulation of the minor papilla is performed (a) when symptoms or imaging studies warrant attempts to diagnose and potentially treat anatomic variations of the pancreatic ductal system and (b) when access to the ventral duct at the major papilla fails or is inadequate to accomplish diagnostic or therapeutic goals in the upstream main duct. The normal development of pancreatic ductal anatomy occurs during the eighth week of gestation with the fusion of the ventral and dorsal pancreas and their respective ducts, resulting in formation of the main pancreatic duct which drains from the dorsal body and tail through the ventral duct of Wirsung in the head to the major papilla and the duodenum. The short segment of dorsal duct extending from the junction between the dorsal and ventral ducts at approximately the genu to the minor papilla becomes the accessory duct or duct of Santorini. The accessory duct and the minor papilla may be patent or only vestigial, without an appreciable lumen.
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Larson, A., Petersen, B.T. (2018). Minor Papilla Cannulation and Endotherapy. In: Sridhar, S., Wu, G. (eds) Diagnostic and Therapeutic Procedures in Gastroenterology. Clinical Gastroenterology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-62993-3_28
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DOI: https://doi.org/10.1007/978-3-319-62993-3_28
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