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Pancreas divisum--advocates and agnostics
A M Cooperman1, J Siegel, H Hammerman
1Department of Surgery, St. Clare's Hospital and Health Center, New York, NY 10019.
Journal of Clinical Gastroenterology
|October 1, 1989
Summary
Pancreas divisum, a common anomaly, presents challenges in surgical candidate selection. Endoscopic stenting aids diagnosis and treatment, but surgical outcomes vary based on follow-up detail.
Area of Science:
- Gastroenterology
- Surgical Anatomy
Background:
- Pancreas divisum is a congenital anomaly where the pancreatic ducts fail to fuse.
- Its high prevalence complicates the precise selection of patients requiring surgical intervention.
- Current diagnostic and therapeutic strategies for pancreas divisum require further evaluation.
Purpose of the Study:
- To define and evaluate treatment criteria for pancreas divisum.
- To assess the efficacy of endoscopic stenting as a diagnostic and therapeutic tool.
- To clarify the role of different surgical procedures based on anatomical and endoscopic findings.
Main Methods:
- Review of criteria for treatment of pancreas divisum.
- Evaluation of endoscopic stenting as a diagnostic and therapeutic modality.
- Analysis of surgical outcomes based on varying follow-up periods and details.
Main Results:
- Selection of surgical candidates for pancreas divisum remains imprecise due to the anomaly's prevalence.
- Endoscopic stenting serves a dual role in both diagnosis and therapy.
- Surgical results appraisal is inconsistent, influenced by follow-up duration and thoroughness.
Conclusions:
- Sphincteroplasty of the dorsal segment is the preferred surgical approach for pancreas divisum in cases with a normal gland.
- Pancreatic resection and caudal drainage are viable alternatives depending on specific anatomical and endoscopic findings.
- Further standardization in follow-up assessments is needed for consistent evaluation of operative results.