Early endoscopic transpapillary drainage through the minor papilla in the treatment of acute pancreatitis.

Background: To explore the feasibility, safety, and efficacy of endoscopic transpapillary drainage through the minor papilla in the treatment of acute pancreatitis (AP). Methods: We retrospectively evaluated the safety and efficacy of endoscopic transpapillary drainage via the minor papilla among AP patients who were treated in our hospital from September 2018 to March 2020. Results: The present study included 18 patients (12 males and 6 females). All patients successfully received endoscopic transpapillary drainage via the minor papilla and were discharged upon recovery. No patient died, received ICU treatment, or had endoscopic operation-related complications. Two patients (11.11%) received additional abdominal paracentesis due to local complications. Fifteen patients (83.33%) resumed oral feeding within 3 days. The postoperative 24-hour leukocyte level, APACHE II score, serum amylase level, and lipase level significantly decreased compared with those at admission. The median hospitalization stay was 5 (3.75-9) days. The median hospitalization cost was 25,123.82 (22,942.50-43,874.68) RMB. The patients were followed up at 6-24 months, during which 4 patients (22.22%) had recurrence. Two patients had recurrence after pancreatic duct removal and other 2 patients in the period of carrying ducts. Conclusions: Early endoscopic transpapillary drainage via the minor papilla in cases of difficult cannulation or stenting via the major papilla is safe and effective in the treatment of AP, and is worthy of further popularization.