Clinical presentation and short-term outcome of endoscopic therapy of patients with symptomatic incomplete pancreas divisum.
BACKGROUND
The clinical significance of incomplete pancreas divisum (IPD) has not been fully described. In this study we report the clinical presentation and results of endoscopic treatment of the 32 (0.6%) patients with IPD seen at our center over a 10-year period.


METHODS
The study population consisted of 24 women and 8 men (mean age 42 years, range 13 to 82 years). Ten (31%) patients presented with acute recurrent pancreatitis, 5 (16%) with chronic pancreatitis, and 3 (9%) with pancreatic type pain. Detailed history, laboratory tests, US, CT, and ERCP excluded other etiologies for their symptoms. The remaining 14 (44%) presented with biliary problems. The 18 symptomatic patients with IPD were treated as follows: 8 received dorsal duct stents, 3 underwent minor papilla endoscopic sphincterotomy and dorsal duct stent placement, 4 had minor papilla dilatation only, and 3 had ventral duct stents placed.


RESULTS
Patients were then followed for recurrence of pancreatitis and pancreatic-type pain. Mean follow-up was 15.5 months (range 3 to 30 months). Six (60%) of the patients with acute recurrent pancreatitis and 4 (80%) with chronic pancreatitis benefitted from the endoscopic therapy. However, only 1 (33%) of the patients with pancreatic-type pain benefitted.


CONCLUSIONS
The clinical presentation and response to endoscopic therapy of patients with ICP appeared to be similar to that of patients with complete pancreas divisum.
Jacob
L
L
Pancreatic Biliary Center, St. Luke's Medical Center, Milwaukee, Wisconsin, USA.
Geenen
J E
JE
Catalano
M F
MF
Johnson
G K
GK
Geenen
D J
DJ
Hogan
W J
WJ
D015746:Abdominal Pain / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D010195:Pancreatitis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome