BACKGROUND AND AIM: The purpose of this study was to assess the feasibility of forward-viewing upper endoscopy for detection of the major duodenal papilla (MDP) as an indicator of the descending duodenum. METHODS: A total of 338 patients were prospectively enrolled. Upper endoscopy was first performed by a routine method for all patients, and a subsequent straightening endoscopic technique, straightening the loop by withdrawal of the scope, was performed if the MDP was not identified during the routine method. RESULTS: Findings of MDP observation using the upper endoscope could be categorized into five types: Type I, whole area of the papilla; Type II, upper part of the papilla, including the orifice; Type III, upper part of the papilla without the orifice; Type IV, lower part of the papilla, including the orifice; Type V, no part of the papilla was found. Upper endoscopy by a routine method detected the MDP in whole or in part in 194 patients (57.4%). Among 144 patients whose MDP could not be detected by use of a routine method, the MDP was identified by a subsequent straightening endoscopic technique in 108 patients (75.0%). Overall rate of observation of the MDP during full upper endoscopy was 89.3% (302/338). Type I is the most frequent (n = 185, 54.7%), followed by Type IV (n = 73, 21.6%), Type II (n = 23, 6.8%), and Type III (n = 21, 6.2%), in that order. CONCLUSIONS: Our results support the value of forward-viewing endoscopy in observation of the MDP. Use of a straightening endoscopic technique, in particular, increases in the rate of detection of the MDP.
BACKGROUND AND AIM: The purpose of this study was to assess the feasibility of forward-viewing upper endoscopy for detection of the major duodenal papilla (MDP) as an indicator of the descending duodenum. METHODS: A total of 338 patients were prospectively enrolled. Upper endoscopy was first performed by a routine method for all patients, and a subsequent straightening endoscopic technique, straightening the loop by withdrawal of the scope, was performed if the MDP was not identified during the routine method. RESULTS: Findings of MDP observation using the upper endoscope could be categorized into five types: Type I, whole area of the papilla; Type II, upper part of the papilla, including the orifice; Type III, upper part of the papilla without the orifice; Type IV, lower part of the papilla, including the orifice; Type V, no part of the papilla was found. Upper endoscopy by a routine method detected the MDP in whole or in part in 194 patients (57.4%). Among 144 patients whose MDP could not be detected by use of a routine method, the MDP was identified by a subsequent straightening endoscopic technique in 108 patients (75.0%). Overall rate of observation of the MDP during full upper endoscopy was 89.3% (302/338). Type I is the most frequent (n = 185, 54.7%), followed by Type IV (n = 73, 21.6%), Type II (n = 23, 6.8%), and Type III (n = 21, 6.2%), in that order. CONCLUSIONS: Our results support the value of forward-viewing endoscopy in observation of the MDP. Use of a straightening endoscopic technique, in particular, increases in the rate of detection of the MDP.
Authors: Hwi Kong; Yong Sik Kim; Jong Jin Hyun; Young Jig Cho; Bora Keum; Yoon Tae Jeen; Hong Sik Lee; Hoon Jai Chun; Soon Ho Um; Sang Woo Lee; Jai Hyun Choi; Chang Duck Kim; Ho Sang Ryu; Jin Hai Hyun Journal: Gastrointest Endosc Date: 2006-10 Impact factor: 9.427