Function of the minor duodenal papilla in humans as determined under duodenoscopy using indigo carmine dye and a pH sensor

Abstract

The function of the minor duodenal papilla in humans was studied by duodenoscopy using indigo carmine dye and a pH sensor. By this method it was possible to classify the function of the minor papilla into three types: Type I: pancreatic juice excretion without secretin administration; Type II: pancreatic juice excretion following secretin administration; Type III: no pancreatic juice excretion despite secretin administration. To determine the relative numbers of each type, the findings in 23 normal subjects were compared with those in 26 patients with benign papillary stenosis. In normal individuals, there were 11 Type I, 4 Type II and 8 Type III, while in patients with papillary stenosis we observed 20 Type I, 4 Type II and 2 Type III function, indicating that in patients with papillary stenosis, the incidence of Type I minor papilla was significantly high. From this it can be inferred that a minor papilla that does not excrete pancreatic juice spontaneously may begin such excretion, if pancreatic duct pressure persistently increases.