A Case Report-Endoscopic Treatments of 47 Incomplete Pancreatic Divisum (IPD) Cases in our Hospital – Special Emphasis on our New Procedures: Rendezvous Pre-Cut Method and Reverse Balloon Dilation Method

Abstract

We have treated 47 cases of incomplete pancreatic divisum (IPD) in theses 7 years. They were classified by the modified“Hirooka’s classification”— stenotic fusion type I / II, ansa pancreatica type, branch fusion type I / II / III, and one was unclassified. 36 cases were treated by ESWL and/or endoscopy. In difficult cases, we performed our new endoscopic procedures-rendezvous precut method and reverse balloon dilation method, with good results. The therapeutic success rate of IPD via major papilla was 100% (10/10) and via minor papilla 96% (24/25) without severe complications. After endoscopic treatment, the prognosis was good in 32, fair in 3 and one had an operation. In calcified IPD cases, endoscopic treatments were performed many times by stone and pain relapse, and EPS is still placed in 24 cases.