Endoscopic dilatation and papillotomy of the accessory papilla and internal drainage in pancreas divisum

In the case of pancreas divisum the minute orifice of the minor papilla has offered a special challenge to endoscopic diagnosis and therapy. Here we describe a method for easy cannulation of the minor papilla and drainage of the pancreatic duct. By means of a flexible guide wire and a dilator, the tiny papilla can be simply dilated, enabling papillotomy to be successfully accomplished. This method has been used in six cases without any major complications, and should pave the way for diagnosis and therapy of pancreas divisum.