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Pancreas Divisum and Minor Papilla Interventions

  • Jay Luther
  • Brenna W. CaseyEmail author
Chapter

Abstract

Pancreas divisum is the most common congenital anomaly of the pancreas. Defined in its classic form by absence of fusion of the dorsal and ventral pancreatic ducts, pancreas divisum has been associated with pancreatitis. Despite this association, its clinical relevance remains uncertain. Endoscopic therapies aimed at improving dorsal pancreatic duct drainage have improved over the years, although its role in the treatment of patients with chronic pancreatitis and chronic abdominal pain, however, is much less established. A randomized, large multi-center, prospective therapeutic trial of endotherapy in symptomatic patients with pancreas divisum is much needed. For now, the risk-benefit ratio of performing ERCP with possible therapeutic intervention needs to be thoroughly reviewed with the patient and care team.

Keywords

Pancreas Divisum Pancreatitis ERCP Ventral Dorsal Duct 

Supplementary material

Video 9.1

Minor papilla intervention. A gentleman with presumed alcohol pancreatitis underwent ERCP for endoscopic intervention of a pancreatic duct stricture visualized on cross-sectional imaging. However, pancreatogram revealed the presence of pancreas divisum. Given this, minor papilla sphincterotomy and duct placement were performed (WMV 16743 kb).

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Clinical and Research Fellow, Gastrointestinal UnitMassachusetts General HospitalBostonUSA
  2. 2.Interventional Gastroenterology, Endoscopic TrainingHarvard Medical SchoolBostonUSA

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