Santoriniplasty in the management of symptomatic pancreas divisum.
OBJECTIVE
To assess the long-term results of sphincteroplasty of the minor papilla in a series of patients with symptomatic pancreas divisum.


METHODS
Retrospective study.


METHODS
University hospital, UK.


METHODS
6 consecutive patients with recurrent acute pancreatitis thought to be caused by pancreas divisum.


METHODS
Surgical enlargement of the minor papilla of Santorini (Santoriniplasty).


METHODS
The effectiveness of the procedure in preventing further episodes of acute pancreatitis and controlling chronic intermittent pancreatic pain, outside documented attacks of pancreatitis.


RESULTS
Median follow up was 4 years (range: 1-6). The procedure was effective in preventing further episodes of recurrent acute pancreatitis (in all patients) but not uniformly good in controlling chronic pancreatic pain (good: 2/6, moderate: 1/6, poor: 3/6).


CONCLUSIONS
The prevention of further attacks of acute pancreatitis by Santoriniplasty indicates that a short term favourable clinical outcome may be achieved by improving drainage of the pancreatic duct through the stenosed minor papilla. Poor pain control may indicate early parenchymal changes or that unsuitable patients had been selected for surgical intervention. At present, there are no objective tests of pancreatic function that can predict which patients are most likely to benefit from Santoriniplasty. Prospective studies with more patients followed up for longer periods of time are needed before the role of the surgical drainage in symptomatic pancreas divisum can be clearly defined.
Tzovaras
G
G
Professorial Surgical Unit, Royal Victoria Hospital, Queen's University of Belfast, United Kingdom.
Rowlands
B J
BJ
D000208:Acute Disease; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010179:Pancreas / Q000473:pathology; D010183:Pancreatic Ducts / Q000601:surgery*; D010195:Pancreatitis / Q000517:prevention & control / Q000601:surgery*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D055502:Secondary Prevention