The usefulness of texture and color enhancement imaging to identify the minor papilla orifice
Abstract In clinical cases of pancreas divisum, endoscopic retrograde cholangiopancreatography often necessitates cannulation of the pancreatic duct through the minor papilla. Nevertheless, this procedure can be challenging because of the small size of the minor papilla and the difficulty in visuali...
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2024-04-01
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| Online Access: | https://doi.org/10.1002/deo2.358 |
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| author | Yoshihiro Goda Kuniyasu Irie Hideyuki Anan Yuichi Suzuki Aya Ikeda Ryosuke Ikeda Hiroaki Kaneko Soichiro Sue Haruo Miwa Shin Maeda |
| author_facet | Yoshihiro Goda Kuniyasu Irie Hideyuki Anan Yuichi Suzuki Aya Ikeda Ryosuke Ikeda Hiroaki Kaneko Soichiro Sue Haruo Miwa Shin Maeda |
| author_sort | Yoshihiro Goda |
| collection | DOAJ |
| description | Abstract In clinical cases of pancreas divisum, endoscopic retrograde cholangiopancreatography often necessitates cannulation of the pancreatic duct through the minor papilla. Nevertheless, this procedure can be challenging because of the small size of the minor papilla and the difficulty in visualizing the ductal orifice. A new image‐enhanced endoscopy technique called texture and color enhancement imaging (TXI) has been developed, which enhances texture, brightness, and color compared with white‐light imaging, resulting in subtle differences in the surface mucosa. Herein, we describe the case of a 73‐year‐old man with pancreas divisum in whom TXI was useful in identifying the orifice of the minor papilla. He was referred to our hospital with repetitive acute exacerbation of chronic pancreatitis. Since contrast‐enhanced computed tomography revealed a pancreatic stone in the main pancreatic duct, endoscopic retrograde cholangoepancreatography was performed as a therapeutic intervention. Despite the initial difficulty in identifying the orifice of the minor papilla on white‐light imaging, TXI enhanced its visibility successfully, enabling dorsal pancreatic duct cannulation via the minor papilla. Subsequently, endoscopic pancreatic sphincterotomy was performed and a 6Fr plastic stent was placed. Post‐endoscopic therapy, the patient's abdominal pain was relieved. TXI was useful in identifying the minor papilla orifice and led to successful cannulation. |
| format | Article |
| id | doaj-art-1dc5e1505fd7400e89287f3c5f43bdf4 |
| institution | Kabale University |
| issn | 2692-4609 |
| language | English |
| publishDate | 2024-04-01 |
| publisher | Wiley |
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| series | DEN Open |
| spelling | doaj-art-1dc5e1505fd7400e89287f3c5f43bdf42025-08-20T03:38:54ZengWileyDEN Open2692-46092024-04-0141n/an/a10.1002/deo2.358The usefulness of texture and color enhancement imaging to identify the minor papilla orificeYoshihiro Goda0Kuniyasu Irie1Hideyuki Anan2Yuichi Suzuki3Aya Ikeda4Ryosuke Ikeda5Hiroaki Kaneko6Soichiro Sue7Haruo Miwa8Shin Maeda9Division of Gastroenterology Yokohama City University School of Medicine Graduate School of Medicine Kanagawa JapanDivision of Gastroenterology Yokohama City University School of Medicine Graduate School of Medicine Kanagawa JapanDivision of Gastroenterology Yokohama City University School of Medicine Graduate School of Medicine Kanagawa JapanDivision of Gastroenterology Yokohama City University School of Medicine Graduate School of Medicine Kanagawa JapanDivision of Gastroenterology Yokohama City University School of Medicine Graduate School of Medicine Kanagawa JapanDivision of Gastroenterology Yokohama City University School of Medicine Graduate School of Medicine Kanagawa JapanDivision of Gastroenterology Yokohama City University School of Medicine Graduate School of Medicine Kanagawa JapanDivision of Gastroenterology Yokohama City University School of Medicine Graduate School of Medicine Kanagawa JapanGastroenterological Center Yokohama City University Medical Center Kanagawa JapanDivision of Gastroenterology Yokohama City University School of Medicine Graduate School of Medicine Kanagawa JapanAbstract In clinical cases of pancreas divisum, endoscopic retrograde cholangiopancreatography often necessitates cannulation of the pancreatic duct through the minor papilla. Nevertheless, this procedure can be challenging because of the small size of the minor papilla and the difficulty in visualizing the ductal orifice. A new image‐enhanced endoscopy technique called texture and color enhancement imaging (TXI) has been developed, which enhances texture, brightness, and color compared with white‐light imaging, resulting in subtle differences in the surface mucosa. Herein, we describe the case of a 73‐year‐old man with pancreas divisum in whom TXI was useful in identifying the orifice of the minor papilla. He was referred to our hospital with repetitive acute exacerbation of chronic pancreatitis. Since contrast‐enhanced computed tomography revealed a pancreatic stone in the main pancreatic duct, endoscopic retrograde cholangoepancreatography was performed as a therapeutic intervention. Despite the initial difficulty in identifying the orifice of the minor papilla on white‐light imaging, TXI enhanced its visibility successfully, enabling dorsal pancreatic duct cannulation via the minor papilla. Subsequently, endoscopic pancreatic sphincterotomy was performed and a 6Fr plastic stent was placed. Post‐endoscopic therapy, the patient's abdominal pain was relieved. TXI was useful in identifying the minor papilla orifice and led to successful cannulation.https://doi.org/10.1002/deo2.358endoscopic retrograde cholangiopancreatographyminor papillapancreas divisumpancreatic ducttexture and color enhancement imaging |
| spellingShingle | Yoshihiro Goda Kuniyasu Irie Hideyuki Anan Yuichi Suzuki Aya Ikeda Ryosuke Ikeda Hiroaki Kaneko Soichiro Sue Haruo Miwa Shin Maeda The usefulness of texture and color enhancement imaging to identify the minor papilla orifice DEN Open endoscopic retrograde cholangiopancreatography minor papilla pancreas divisum pancreatic duct texture and color enhancement imaging |
| title | The usefulness of texture and color enhancement imaging to identify the minor papilla orifice |
| title_full | The usefulness of texture and color enhancement imaging to identify the minor papilla orifice |
| title_fullStr | The usefulness of texture and color enhancement imaging to identify the minor papilla orifice |
| title_full_unstemmed | The usefulness of texture and color enhancement imaging to identify the minor papilla orifice |
| title_short | The usefulness of texture and color enhancement imaging to identify the minor papilla orifice |
| title_sort | usefulness of texture and color enhancement imaging to identify the minor papilla orifice |
| topic | endoscopic retrograde cholangiopancreatography minor papilla pancreas divisum pancreatic duct texture and color enhancement imaging |
| url | https://doi.org/10.1002/deo2.358 |
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