Gut Liver.  2016 May;10(3):476-482. 10.5009/gnl15362.

Endoscopic Intervention through Endoscopic Retrograde Cholangiopancreatography in the Management of Symptomatic Pancreas Divisum: A Long-Term Follow-Up Study

• Lu Y
• Xu B
• Chen L
• Bie LK
• Gong B

• KMID: 2411977
• DOI: http://doi.org/10.5009/gnl15362

Abstract

BACKGROUND/AIMS
To evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) for the treatment of symptomatic pancreas divisum (PD) and to discuss whether ERCP procedures and outcomes in younger patients differ from those of adults.
METHODS
Symptomatic patients with PD were included in the study and divided into underaged (age ≤17 years) and adult (age ≥18 years) group. The clinical information of each patient was reviewed, and then the patients were contacted by telephone or their medical records were reviewed to determine their long-term follow-up outcomes.
RESULTS
A total of 141 procedures were performed in 82 patients (17 underaged and 65 adult patients). The ERCP indications included abdominal pain (39.02%), pancreatitis (12.20%), recurrent pancreatitis (36.59%), and other discomfort (12.20%). The endoscopic interventions included endoscopic pancreatic sphincterotomy in 44.68% of the patients, bouginage in 26.95%, pancreatic ductal stone extraction in 19.15%, endoscopic nasopancreatic drainage in 21.99%, and endoscopic retrograde pancreatic drainage in 56.74%. After a median follow-up of 41 months, the overall response rate was 62.32%. Between the underaged group and the adult group, significant differences were not observed in the ERCP procedures, complications and long-term follow-up results.
CONCLUSIONS
ERCP is a safe and effective treatment for symptomatic PD. Based on the details, complications, and follow-up results, the ERCP procedure did not present differences between the underaged and adult groups.

Keyword

Pancreas divisum; Endoscopic retrograde cholangiopancreatography; Endoscopic pancreatic sphincterotomy; Endoscopic nasopancreatic drainage; Endoscopic retrograde pancreatic drainage

MeSH Terms

Abdominal Pain/etiology/therapy
Adolescent
Adult
Aged, 80 and over
Calculi/diagnostic imaging
Child
Child, Preschool
*Cholangiopancreatography, Endoscopic Retrograde
Duodenoscopy/methods
Female
Follow-Up Studies
Humans
Male
Middle Aged
Pancreas/*abnormalities/diagnostic imaging
Pancreatitis, Chronic/diagnostic imaging/etiology/therapy
Treatment Outcome
Young Adult