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Publication Name
World Journal of Gastrointestinal Endoscopy
ISSN
1948-5190
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Case Report
Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Endosc. Nov 16, 2026; 18(11): 126966
Published online Nov 16, 2026. doi: 10.4253/wjge.126966
Nursing management for patients with minor papilla stent placement after failed endoscopic retrograde cholangiopancreatography cannulation: Two case reports
Hui-Bing Jin, Jin-Hong Huang, Sen-Shi Wang, Shi-Xue Dai, Yue Li, Liang-Fang Li
Hui-Bing Jin, The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, Guangdong Province, China
Jin-Hong Huang, Sen-Shi Wang, Yue Li, Liang-Fang Li, Digestive Endoscopy Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou 510080, Guangdong Province, China
Shi-Xue Dai, Department of General Practice, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou 510080, Guangdong Province, China
Co-first authors: Hui-Bing Jin and Jin-Hong Huang.
Co-corresponding authors: Yue Li and Liang-Fang Li.
Author contributions: Jin HB, Li LF, and Wang SS contributed to conceptualization, data collection, and manuscript drafting; Huang JH contributed to data verification and critical revision; Dai SX assisted with editing design and language. Li Y and Li LF served as co-corresponding authors. Li Y oversaw the overall research framework, was in charge of research quality control, coordinated communications with the journal throughout the submission and revision process, and bears primary responsibility for responding to academic queries and reviewer comments. Li LF led the clinical implementation of this study, was responsible for confirming the authenticity and integrity of all clinical data, and supervised the clinical interpretation of the findings. Both co-corresponding authors jointly reviewed and approved every revised version of the manuscript, shared accountability for all aspects of the work, and are jointly accountable for ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Li Y contributed to the supervision and final approval; and all authors approved the final version of the manuscript. All authors met the ICMJE criteria for authorship.
AI contribution statement: During the preparation of this manuscript, the authors used Deepseek and Kimi solely for the purpose of language polishing and grammar refinement. The authors carefully reviewed and edited the content generated or altered by the AI tools, and take full responsibility for the integrity, accuracy, and scientific validity of the final manuscript.
Informed consent statement: Written informed consent was obtained from both patients for the publication of this case report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Liang-Fang Li, Associate Chief Nurse, Digestive Endoscopy Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, No. 106 Zhongshan Er Road, Guangzhou 510080, Guangdong Province, China. liliangfang@gdph.org.cn
Received: August 24, 2026
Revised: October 8, 2026
Accepted: October 29, 2026
Published online: November 16, 2026
Processing time: 83 Days and 13.8 Hours
Abstract
BACKGROUND

Endoscopic retrograde cholangiopancreatography (ERCP) is the standard intervention for pancreatic ductal drainage. Selective cannulation of the main pancreatic duct via the major papilla fails in 5%-10% of cases due to anatomic variants, particularly suspected pancreas divisum, and cannulation often occurs via the minor papilla.

CASE SUMMARY

This case report describes two patients (a 37-year-old female and a 71-year-old female) who presented with pancreatic ductal dilation and underwent ERCP for diagnostic and therapeutic purposes. In both cases, selective cannulation of the main pancreatic duct via the major papilla failed after repeated attempts; however successful minor papilla cannulation and pancreatic stent placement were achieved without intraprocedural or postprocedural complications, including post-ERCP pancreatitis, bleeding, or perforation at the 1-month follow-up. This report emphasizes the critical role of comprehensive nursing interventions throughout the perioperative period.

CONCLUSION

Preoperatively, nurses contributed to risk identification by thoroughly reviewing imaging and anatomical variations. Intraoperatively, they ensure seamless instrument preparation, timely device exchange, and steady guidewire stabilization, which are pivotal for procedural success. Postoperatively, a standardized “fasting-enzyme inhibition-fluid resuscitation” protocol was strictly implemented to enable early detection and prompt management of potential complications. These nursing strategies optimize outcomes in this high-risk population, offering a forward-looking nursing perspective for minor papillary cannulation, and proposing a nursing framework for such complex procedures.

Keywords: Endoscopic retrograde cholangiopancreatography; Minor papilla; Pancreatic stent; Nursing care; Pancreas divisum; Case report

Core Tip: This case report describes the nursing care of two patients undergoing minor papilla pancreatic stent placement after failed major papilla cannulation during endoscopic retrograde cholangiopancreatography (ERCP). We propose a three-component nursing framework encompassing preprocedural imaging review to identify anatomical variants and prepare specialized instruments, intraprocedural “major-first, minor-second” sequential strategy with coordinated guidewire manipulation, and a postprocedural “fasting-enzyme inhibition-fluid resuscitation” protocol for post-ERCP pancreatitis prevention. These nursing strategies may be helpful for optimizing outcomes in this high-risk population and provide practical guidance for endoscopy nursing teams.
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