A systematic review on endoscopic detection rate, endotherapy, and surgery for pancreas divisum

Liao, Zhuan; Gao, Rong; Wang, W.; Ye, Z.; Lai, Xiaowei; Wang, X.-T.; Hu, Liang‐Hao; Li, Z.-S.

doi:10.1055/s-0029-1214505

Cited by 96 publications

(78 citation statements)

References 9 publications

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“…This condition is found in 5% to 14% of the general population [1]. In a large retrospective study from India, pancreas divisum was more frequent in patients with pancreatitis than in those with biliary diseases or obscure abdominal pain (9 versus 2 percent).…”

Section: Discusionmentioning

confidence: 99%

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Pancreas Divisum Causing Recurrent Pancreatitis: A Case Report

Siddiqui¹,

Sultan²,

Shaikh³

2017

Int J Med Rev Case Rep

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Background: Pancreas divisum is one of the rare causes of recurrent pancreatitis. Diagnosis is challenging and diagnostic failure leads to recurrent episodes of pancreatitis and ultimately pancreatic failure. Case: Here we are presenting a case of a young female with a history of recurrent attacks of upper abdominal pain which on work up was diagnosed as pancreas divisum. This patient was successfully treated with ERCP with minor papillotomy followed by stenting in major papilla. Written informed consent was taken from the patient before writing this case report.Conclusion: This report emphasises the need for early suspicion of disease, in patients with recurrent idiopathic pancreatitis, by clinician and efficacy of minimally invasive procedures (ERCP) as a definitive treatment option.

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Section: Discusionmentioning

confidence: 99%

“…The incidence is variable, but it ranges from 5% to 14% of the general population [1]. The disease occurs due to failure of fusion of the two embryonic parts of the pancreas i.e.…”

Section: Introductionmentioning

confidence: 99%

Pancreas Divisum Causing Recurrent Pancreatitis: A Case Report

Siddiqui¹,

Sultan²,

Shaikh³

2017

Int J Med Rev Case Rep

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“…The difference is believed to be due to under recognition in ERCP and referral bias. In a recent systematic review of ERCP based detection rates of PD, further variation was noted based on various geographical location [9]. While the overall endoscopist detected PD was 2.9%, it was found to be 1.5% in Asia, 5.7% in United States, and 6% in Europe [9].…”

Section: What Is the Prevalence Of Pd?mentioning

confidence: 99%

“…In a recent systematic review of ERCP based detection rates of PD, further variation was noted based on various geographical location [9]. While the overall endoscopist detected PD was 2.9%, it was found to be 1.5% in Asia, 5.7% in United States, and 6% in Europe [9]. This geographical variation in prevalence of PD may however be attributed to the extent the endoscopist search for it and the referral bias rather than its true prevalence [8,9].…”

Section: What Is the Prevalence Of Pd?mentioning

confidence: 99%

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Pancreatic Divisum: Beyond what is Obvious

2014

Pancreat Disord Ther

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In over 90% of healthy people, the dorsal and ventral endodermal pancreatic buds fuse to form the adult pancreas. However, in about the remaining 10% of the population where the fusion does not occur, pancreatic divisum (PD) results. This indeed is the commonest congenital anomaly of pancreas. The dorsal root usually drains a part of pancreatic head, the body and tail of the pancreas via a minor papilla into the duodenum. The ventral root drains the uncinate process and part of the pancreatic head with the CBD via the major papilla into the duodenum and the two roots are communicated with one another. In classic PD (type1) there is a complete failure of fusion of ducts, and a small ventral duct (Santorini) drains through the larger major papilla, and a larger dorsal duct (Wirsung) drains through the smaller minor papilla. In type 2, there is a complete absence of duct of Wirsung. While in type (incomplete PD), there is a filamentous or tiny caliber communication between the dominant dorsal duct of Wirsung and duct of Santorini. In the western countries, the incomplete PD is uncommon with a reported incidence of 0.13%-0.9%. However recent reports from Japan and Korea show a much higher prevalence of 48% to 52%, of incomplete PD. In patients with a large duct, the majority of the pancreatic secretions pass through the minor papilla (instead of major) resulting in inadequate drainage and pain caused by obstruction. However while these features of PD are relatively well known, there are some aspects of PD, which are not so obvious. These include its true prevalence, its role in development of pancreatitis and carcinoma of pancreas, the genetic abnormalities and its association with pancreatitis in presence of PD and the appropriate management of these patients when symptomatic

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The Frey Procedure for Chronic Pancreatitis Secondary to Pancreas Divisum

et al. 2013

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In this series, outcomes for patients with CPPD treated with the Frey procedure were equivalent to those treated for CPA. Patients with pancreas divisum and a dilated pancreatic duct may be ideally suited for this surgical strategy. The potential advantage of this approach over minor duct sphincteroplasty and lateral pancreaticojejunostomy is the removal of the fibrotic tissue of the head of the pancreas, thought to be the epicenter of pain in this condition. The benefits over resection alone include a more extensive ductal drainage procedure.

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A systematic review on endoscopic detection rate, endotherapy, and surgery for pancreas divisum

Cited by 96 publications

References 9 publications

Pancreas Divisum Causing Recurrent Pancreatitis: A Case Report

Pancreas Divisum Causing Recurrent Pancreatitis: A Case Report

Pancreatic Divisum: Beyond what is Obvious

The Frey Procedure for Chronic Pancreatitis Secondary to Pancreas Divisum

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