title: Endoscopic minor papilla sphincterotomy in patients with santoriniceles reduces pain and improves quality of life.
abstract: BACKGROUND
  Pancreas divisum patients with focal obstruction of the minor papilla and resulting dilation of the dorsal pancreatic duct [a santorinicele (SC)] have been reported to improve with endoscopic sphincterotomy of the minor papilla (ESMP). In this study, we assess the long-term efficacy of ESMP in SC patients.
  
  
  METHODS
  A retrospective review of the endoscopic database was performed. Fifteen patients with SCs were identified. A follow-up questionnaire was mailed to patients to assess for changes in quality of life (QOL), narcotic use, hospital admissions, and pain after ESMP.
  
  
  RESULTS
  Fifteen patients were mailed questionnaires and 11 responses were obtained. The average pain score prior to ESMP was 8.6/10 (SD ± 1.7) and significantly decreased to 2.7/10 (SD ± 2.0) (p < 0.05) after treatment. Six patients required narcotics before ESMP and none used narcotics for recurrent pancreatic type pain after. Nine patients had recurring admissions for pancreatitis prior to ESMP while only two were admitted after treatment. Mean QOL score prior to ESMP was 4.5/10 (SD ± 2.7) and increased significantly to 8.4/10 (SD ± 1.3) (p < 0.05) with two patients rating their QOL at 10/10.
  
  
  CONCLUSIONS
  QOL, narcotic use, hospital admissions, and pain scores all improved with ESMP. Endoscopic therapy for this uncommon condition appears both justified and potentially curative.
authors: Virginia Mason Medical Center, Mailstop: C3GAS, 1100 9th Avenue, Seattle, WA 98101, USA. glutzak@ualberta.ca
authors: Gregory D
authors: GD
authors: Lutzak
authors: Michael
authors: M
authors: Gluck
authors: Andrew S
authors: AS
authors: Ross
authors: Richard A
authors: RA
authors: Kozarek
mesh_terms: D000328:Adult; D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000601:surgery; D010147:Pain Measurement; D010182:Pancreatic Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D010183:Pancreatic Ducts / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
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