ABSTRACT
Objective To evaluate the efficacy and safety of endoscopic therapy in the treatment of symptomatic pancreatic divisum (PD).Methods Data of 8 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) with the diagnosis of pancreas divisum at our institution from June 2006 to June 2013 was retrospectively analyzed.Results The patients were identified as pancreatic divisum with 28 ERCP procedures.All patients received stent placement,7 underwent minor papilla sphincterotomy,6 pancreatic duct stricture dilatation,and 1 stone extraction.Post-endoscopic retrograde cholangiopancreatography pancreatitis occurred in 1 patient,and no other complications occurred.After a follow-up of 2-47 months,1 patient died of pancreatic carcinoma,3 patients removed the stents,3 patients were followed up regularly,and 1 was unavailable for the interview.The episode of chronic pancreatitis and the extent of abdominal pain decreased after the operations.Conclusion Endoscopic therapy is effective and safe for the pancreatic divisum patients.It can reduce the episode of chronic pancreatitis and relieve the chronic abdominal pain in PD patients with low incidence of complication.
ABSTRACT
Intraductal papillary mucinous neoplasms (IPMNs) are premalignant lesions that require a surgical resection. IPMN can cause abdominal pain or pancreatitis as a result of either mucin production or a papillary growth, resulting in a ductal obstruction. Most IPMNs arise from the main pancreatic duct. However, IPMNs arising from the accessory pancreatic duct are extremely rare. Pancreatic divisum occurs when the ventral and dorsal ducts of the pancreas fail to fuse during organogenesis. It is the most common congenital variant of pancreatic-ductal development, and occurs in approximately 10~14% of individuals. Although pancreatic divisum has no clinical relevance, some patients present with acute recurrent or chronic pancreatitis. In most cases, it is discovered incidentally during an examination of pancreatitis, and is occasionally accompanied by a pancreatic tumor. We report the first case of IPMN in a patient with an incomplete pancreatic divisum in Korea.