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Related Experiment Videos

Pancreas divisum.

S Varshney1, C D Johnson

  • 1University Surgical Unit, Southampton General Hospital, UK. varshney@btinternet.com

International Journal of Pancreatology : Official Journal of the International Association of Pancreatology
|June 9, 1999
PubMed
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Pancreas divisum (PD) is a common congenital anomaly. While often asymptomatic, PD complications like pancreatitis may require specific therapies, with outcomes varying by patient group and treatment approach.

Area of Science:

  • Gastroenterology
  • Medical Diagnostics
  • Surgical Therapy

Background:

  • Pancreas divisum (PD) is the most common congenital pancreatic anomaly, affecting up to 10% of the population.
  • Symptomatic complications in individuals with PD are infrequent, occurring in approximately 5% of cases.
  • Obstructive pancreatitis in PD likely requires coexisting factors, such as minor papilla insufficiency.

Purpose of the Study:

  • To review diagnostic modalities for pancreas divisum.
  • To outline therapeutic strategies for symptomatic pancreas divisum.
  • To assess treatment outcomes based on clinical presentation and intervention.

Main Methods:

  • Diagnostic imaging including endoscopic retrograde cholangiopancreatography (ERCP), secretin-stimulated ultrasonography, computed tomography (CT), and magnetic resonance cholangiopancreatography (MRCP).

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  • Clinical classification of symptomatic PD patients into five groups based on symptom severity and complications.
  • Evaluation of therapeutic responses to medical, endoscopic, and surgical interventions.

    • Main Results:

    • MRCP is a promising noninvasive diagnostic tool that may eventually replace ERCP.
    • Therapeutic outcomes for minor papilla intervention vary significantly by patient group: good (75-90%) in group 2, moderate (40-60%) in group 3, and poor (20-40%) in group 4.
    • Medical therapy is recommended for minimal symptoms (group 1), while other pancreatic surgeries may be necessary for complex cases.

    Conclusions:

    • Careful patient selection and tailored therapy are crucial for achieving favorable outcomes in pancreas divisum management.
    • Pancreas divisum alone may not cause obstructive pancreatitis; associated conditions like minor papilla insufficiency are likely implicated.
    • A multi-modal approach combining diagnostics and targeted therapies improves management of symptomatic pancreas divisum.