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Updated: Jul 18, 2026
Collection Protocol for Human Pancreas
Published on: May 23, 2012
[Bilobular pancreas: another variant of the divided pancreas?]
Dragana Zivanović1, Vojislav N Perisić
1Univerzitetska decja klinika, Odeljenje za hepatobilijarne poremećaje, Beograd, Srbija.
Insights
Pancreas divisum, a common pancreatic anomaly, can cause recurrent pancreatitis. A rare "bilobular pancreas" variant in a child required sphincteroplasty for complete disease control.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Medical Imaging
Background:
- Pancreas divisum is the most common congenital pancreatic anomaly.
- It is frequently associated with recurrent pancreatitis.
- The underlying pathophysiology linking pancreas divisum to pancreatitis is debated.
Purpose of the Study:
- To investigate a rare variant of pancreas divisum, termed "bilobular pancreas".
- To assess the clinical presentation and management of a child with this variant and severe acute pancreatitis.
- To evaluate the efficacy of surgical intervention for this specific pancreatic anomaly.
Main Methods:
- Computed tomography (CT) of the abdomen was performed in 5 children with confirmed pancreas divisum.
- Endoscopic cholangiopancreatography was used to diagnose pancreas divisum.
- A case of a child with a completely divided embryonal dorsal and ventral pancreas (bilobular pancreas) experiencing severe acute pancreatitis is detailed.
Main Results:
- A unique variant, the "bilobular pancreas", was identified, characterized by completely separated dorsal and ventral pancreatic primordia.
- Four children with pancreas divisum achieved symptom control with medical management (pharmacotherapeutics and diet).
- One patient with the bilobular pancreas variant and severe acute pancreatitis experienced complete disease control after sphincteroplasty of the papilla duodeni minor.
Conclusions:
- The "bilobular pancreas" variant, with anatomically separate ductal systems, may be a key factor in pancreatic disease severity.
- Sphincteroplasty of the papilla duodeni minor is presented as a potentially effective therapeutic method for this specific anomaly.
- This finding suggests a potential surgical indication for managing severe pancreatitis in patients with this rare pancreatic variant.
Background:
Pancreas divisum is the most common anomaly of the pancreas. This anomaly has been known as a possible cause of recurrent pancreatitis.
Case Report:
We performed computerized tomography (CT) of the abdomen in 5 children in whom a divided pancreas was confirmed using endoscopic cholangiopancreatography. In a girl, who had three episodes of severe acute pancreatitis, a CT examination confirmed a completely divided embryonal dorsal and ventral primordium. We named this variant of the divided pancreas the "bilobular pancreas". Contrary to the remaining 4 children in whom the control of the number and severity of attacks, as well as the control of pancreatic pain were achieved by pharmacotherapeutics and an adequate diet, in the reported patient sphincteroplasty of the papilla duodeni minor resulted in a full control of the disease.
Conclusion:
The paper discussed the possibility that the variant of the divided pancreas, with anatomically completely separated ventral and dorsal pancreas and their ductal systems, is the key factor that determines the severity of pancreatic disease and an indication for sphincteroplasty of the papilla duodeni minor as the major therapeutic method.
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