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Endoscopic treatment in pancreas divisum
S D Coleman1, G M Eisen, A B Troughton
1Division of Gastroenterology, Duke University Medical Center, Durham, North Carolina.
Objectives:
We have reviewed the results of endoscopic stenting with and without sphincterotomy at the minor papilla in 34 patients with pancreas divisum and pain or pancreatitis.
Methods:
Symptoms before and after the procedure were scored and compared, as was the patient's estimate of the overall effectiveness of the treatment.
Results:
A statistically significant improvement in pain score was found in patients with acute recurrent pancreatitis and in patients with chronic pancreatitis, but not in a small group of patients suffering pain without pancreatitis. The overall effectiveness was found to be 78%, 60%, and 40%, respectively, for these three groups. Complications of treatment were common, but usually mild. There were no evident differences in outcomes between patients who did or did not undergo sphincterotomy of the minor papilla.
Conclusions:
This study confirms that there is a subgroup of patients with symptomatic pancreas divisum who improve with endoscopic treatment. Correctly identifying these individuals remains a challenge.