Background: Pancreas divisum is the most common anatomical variation of pancreatic ductal system affecting 5-10% of population. Therapy includes different endoscopic and surgical procedures. The aim of this article was to summarize actual evidence of different treatment.
Methods: A Medline search was performed to identify all studies, investigating endoscopic or surgical therapy of Pancreas divisum. An individual data simulation model was applied to compare endoscopic and surgical studies.
Result: 56 observational studies (31 endoscopic and 25 surgical studies) were included in analyses. Surgery was significantly superior to endoscopic treatment in terms of success rate (72% vs. 62.3), complication rate (23.8% vs. 31.3%) and re-intervention rate (14.4% vs. 28.3%).
Conclusion: Surgery may be superior to endoscopy in terms of treatment success and complications. There is no study comparing these two therapies. Consequently, a randomized trial is needed to clarify if endoscopy or surgery is superior in the therapy of pancreas divisum.
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http://dx.doi.org/10.1016/j.amjsurg.2016.12.025 | DOI Listing |
Rev Esp Enferm Dig
January 2025
Gastroenterology , Hospital Universitario Dr. José Eleuterio González, México.
We report the case of a 59-year-old woman with a history of smoking, hypertension, and prior surgeries. She presented with acute right upper quadrant abdominal pain radiating to the back. Laboratory tests revealed elevated liver enzymes and imaging studies (CT and MRCP) showed a dilated common bile duct.
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of General, Abdominal, Vascular and Transplant Surgery, Otto-von-Guericke University with University Hospital, Leipziger Str. 44, 39120 Magdeburg, Germany.
: Drawing upon over twenty years of clinical experience in endoscopic and endosonographic procedures, along with comprehensive literature research, we present an overview on EUS-guided pancreatography and pancreatic duct drainage (EUS-PD) as an alternative approach, encompassing indications, procedural methods, and outcomes, including complications and the success rate. Narrative review. (corner points): EUS-PD is indicated for cases, for which conventional methods are ineffective due to altered abdominal anatomy of the upper gastrointestinal (GI) tract, such as congenital or postoperative conditions that prevent access to the papilla or pancreatoenteric anastomosis.
View Article and Find Full Text PDFGastrointest Endosc
December 2024
Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Pancreatic Diseases, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China. Electronic address:
Background And Aims: Pancreas divisum (PD) is the most common developmental anatomic variant of pancreatic duct. The published data on the accuracy of the detection of pancreas divisum by linear-array endoscopic ultrasound (L-EUS) is limited. The current study aimed to assess the diagnostic accuracy of L-EUS compared with magnetic resonance cholangiopancreatography (MRCP) for identifying PD.
View Article and Find Full Text PDFFukushima J Med Sci
January 2025
Department of Pediatrics, Japan Self Defense Forces Central Hospital.
Acute pancreatitis in children in Japan is often caused by an anatomical abnormality of the pancreatic and bile duct, resulting in fever, abdominal pain, vomiting, diarrhea, and other symptoms. Crohn's disease, however, is a chronic granulomatous inflammatory bowel disease with ulcerative lesions of the intestinal tract of unknown cause that occurs mainly in young people, with symptoms similar to those of acute pancreatitis. We report a case of acute pancreatitis diagnosed in a patient not only with incomplete fusion of the pancreatic duct but also with Crohn's disease.
View Article and Find Full Text PDFArq Bras Cir Dig
December 2024
From Universidade Federal do Maranhão, Hospital Universitário Presidente Dutra, Department of Gastrointestinal Surgery, Hepatopancreatobiliary and Liver Transplant Unit - São Luis (MA), Brazil.
Background: Pancreas divisum is an anatomical abnormality where the junction of the main and accessory pancreatic duct fails to occur and the smaller-caliber duct acts as dominant, resulting in overload during the drainage of the organ's secretion through the minor duodenal papilla.
Aims: To report a case of recurrent acute pancreatitis due to symptomatic pancreas divisum who underwent pancreatoduodenectomy.
Case Report: A 21-year-old male patient presented with intermittent painful crises, located in the upper abdomen, with radiation to the back, associated with nausea and vomiting, for the past three years.
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