title: Accessory sphincterotomy (endoscopic and surgical) in patients with pancreas divisum.
abstract: Sixteen patients with the congenital anomaly of pancreas divisum have been treated by enlarging the orifice of the accessory papilla. Attempts to do this at duodenoscopy succeeded in only 5 of 12 patients, and only one had a good clinical result. Sphincteroplasty was performed surgically in seven patients; five had a good or fair result. Most patients with poor results have undergone pancreatic resection. One patient died post-operatively; the remaining 15 divide equally as good (5), fair (5) and poor (5) results at follow-up after periods ranging from 7 months to 5 years. Results appear to be better in patients presenting with recurrent attacks of acute pancreatitis than in those with chronic pain. The preferred management for these patients remains unclear.
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D004384:Duodenoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D010179:Pancreas / Q000002:abnormalities*; D010183:Pancreatic Ducts / Q000601:surgery*; D010195:Pancreatitis / Q000209:etiology; D012008:Recurrence