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Pancreas divisum. A predisposing factor to pancreatitis?
T Hayakawa1, T Kondo, T Shibata
12nd Department of Internal Medicine, Nagoya University School of Medicine, Japan.
Summary
Pancreas divisum (PD) is a congenital condition where the pancreatic ducts fail to fuse. This study suggests PD is not a predisposing factor for pancreatitis in Japan, appearing to be a coincidental finding.
Area of Science:
- Gastroenterology
- Medical Research
Background:
- Pancreas divisum (PD) is a common congenital anomaly of the pancreatic duct system.
- The association between PD and pancreatic diseases, particularly pancreatitis, remains controversial.
Purpose of the Study:
- To investigate the incidence of PD in Japanese patients.
- To determine if PD is associated with specific diseases, including pancreatitis, pancreatic cancer, and cholelithiasis.
- To compare PD incidence and associated diseases between Japanese and English patient series.
Main Methods:
- Retrospective review of patient cases diagnosed with PD over 10 years.
- Analysis of endoscopic pancreatograms (ERP) for PD diagnosis.
- Comparison of PD incidence and disease associations with published Japanese and English series.
Main Results:
- PD was diagnosed in 0.64% of 3121 Japanese patients undergoing ERP.
- Among PD patients, incidences of acute pancreatitis (2.6%), chronic pancreatitis (0.8%), ampullary cancer (20%), and cholelithiasis (0.8%) were observed.
- Japanese PD incidences were similar to other Japanese series but differed from English series, which showed higher rates of pancreatitis and pancreatic cancer.
Conclusions:
- The data suggest that pancreas divisum is a coincidental finding in Japan and not a predisposing factor for pancreatitis.
- Observed higher incidences of pancreatitis and pancreatic cancer in English series may be due to higher overall PD prevalence in those populations.
- Further research is needed to clarify the controversial relationship between PD and pancreatitis globally.