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• W2912460268 abstract "Introduction: Pancreas divisum (PD) is a common anatomic variant found in approximately 7% of the population. Management approaches in patients with divisum include medical therapy, endoscopic papillotomy with stent placement, and surgical therapy. This study evaluated a large single center experience in the endoscopic management of PD patients with recurrent acute pancreatitis. Methods: This retrospective study included patients with PD undergoing ERCP from period of April 2009 to November 2016. Various demographic and procedural parameters were collected. Data was abstracted from the medical record to follow the treatment course of patients with PD through the study time period. Results: A total of 174 ERCPs were performed on 82 patients during the study period. The average age of the patients was 45.6 years, 49.3 % were male, 58.5% were Caucasian. 64.6 % (n=53) patients had complete divisum. A total of 5 (5.8%) patients had IPMN, 3 (3.5%) patients had a santorinicele and none of the patient had a pancreatobiliary cancer. A single case of annular pancreas and another single case of anomalous pancreatobiliary junction was diagnosed. 35.3% (n=29) patients were active smokers, 29.2% (n=23) consumed alcohol and 37.8% (n=31) patients were on chronic opioids. 54 patients (31%) were admitted to the hospital post ERCP with an average length of stay of 4.2 days. Out of 82 patients, 36 underwent one ERCP with minor papillotomy. Cannulation was unsuccessful in 7 patients and surgical referral was made. 39 patients required multiple ERCPs (on average 3.2 ERCPs, range 2 to 8). Interventions such as minor papillotomy, balloon sweeps and pancreatic duct stent placement with gradual upsizing of stent were performed. At the end of follow up, 56 patients (68.2%) had clinical success, 19 patients (23.1%) had no response to endotherapy. 7 patients (8.5%) were lost follow up. 9 (5.2%) patients developed post ERCP pancreatitis, 3 patients had post papillotomy bleeding controlled with endoscopic intervention and 24 patients had non-pancreatitis post procedure abdominal pain. No deaths were observed. Conclusion: Endoscopic intervention with minor papillotomy and pancreatic duct stent placement with gradual stent upsizing appears to be safe and effective in a carefully selected cohort of patients with divisum presenting with recurrent acute pancreatitis. Prospective studies on the comparative efficacy, impact on quality of life, and healthcare costs are indicated." @default.
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• W2912460268 date "2017-10-01" @default.
• W2912460268 modified "2023-09-26" @default.
• W2912460268 title "Safety and Efficacy of Endoscopic Treatment in Pancreas Divisum in Patients With Recurrent Acute Pancreatitis" @default.
• W2912460268 doi "https://doi.org/10.14309/00000434-201710001-02658" @default.
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