AI Article Synopsis
- The study evaluated the factors influencing the success rate and safety of endoscopic minor papilla sphincterotomy (EMPS) in patients with symptomatic pancreas divisum from 2009 to 2020.
- Technical success was achieved in 82.1% of patients, with pancreatic calcifications identified as a significant predictor of failure, while 93% of patients experienced a reduction in acute pancreatitis episodes after the procedure.
- The overall adverse event rate was 14.9%, with post-ERCP pancreatitis as the most common complication, indicating that EMPS may be a promising treatment option for recurrent pancreatitis.
Article Abstract
Background: We aimed to assess factors impacting the endoscopic minor papilla sphincterotomy (EMPS) success rate, clinical efficacy, and safety in a large cohort of patients with symptomatic pancreas divisum (PD).
Methods: Retrospective study including patients with PD referred to the Pancreas Institute of Verona from May 2009 to May 2020 to undergo EMPS. The whole population was analyzed to assess EMPS technical success, defined as the rate of deep cannulation of the dorsal duct. Patients treated for recurrent pancreatitis (RP) with a minimum follow-up of 1 year were included to evaluate the clinical efficacy, defined as resolution or significant reduction of acute pancreatitis (AP) episodes. Safety was defined as the rate of procedure-related adverse events (AEs) according to an international lexicon. The effects of the main determinants on study outcomes were evaluated.
Results: Overall, 106 patients were evaluated. Technical success was obtained in 87 (82.1%). The presence of pancreatic calcifications was associated with failure (p < 0.0001). Clinical efficacy was evaluated in 59 patients. Resolution/reduction of AP episodes after EMPS was observed in 93% of patients over a median follow-up of 49 months (IQR 37-92). Smoking habit was associated with AP recurrence (p = 0.026). The overall AE rate was 14.9%, with post-ERCP pancreatitis as the most common complication (12.6%).
Conclusions: In our study, performed at a tertiary center, EMPS showed satisfactory technical success and an acceptable safety profile. If confirmed by prospective multicenter studies, EMPS could become the standard of care for the treatment of RP in PD.
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| http://dx.doi.org/10.1016/j.pan.2021.01.019 | DOI Listing |
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