Abstract | CONTEXT: OBJECTIVE: To describe a retrospective study of endoscopic minor papillotomy for pancreas divisum. PATIENTS: Eighty-nine adult patients who underwent endoscopic minor papillotomy at our referral center were included in the study. Median follow-up was 29 months. INTERVENTION: We conducted a telephone survey. Fifty-three patients were available for the telephone survey. RESULTS: Thirty-two patients (60.4%) reported immediate improvement: however, symptoms recurred in 17 (53.1% of the immediate responders). Repeat endoscopic interventions were performed in 8 patients, with long-term improvement in two. Overall long-term improvement was achieved in 17 patients (32.1%). Results of minor papillotomy were more favorable for patients with recurrent, well-defined bouts of pancreatitis (immediate improvement: P=0.036; long-term improvement: P=0.064) compared to those with pancreatitis who reported continuous pain and those without clinical evidence of pancreatitis (immediate improvement: 73.3%, 42.9% and 44.4%, respectively; long-term improvement: 43.3%, 21.4%, and 11.1%, respectively). CONCLUSIONS: The long-term benefit from endoscopic minor papillotomy using strict criteria is poorer than suggested from previous studies. However, pancreas divisum patients with well-defined bouts of pancreatitis are more likely to benefit from endoscopic minor papillotomy than those without symptom-free intervals between "attacks" and those with pain that is not associated with elevated pancreatic enzymes.
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Authors | Henning Gerke, Michael F Byrne, Helen L Stiffler, Jorge V Obando, Robert M Mitchell, Paul S Jowell, Malcolm S Branch, John Baillie |
Journal | JOP : Journal of the pancreas
(JOP)
Vol. 5
Issue 3
Pg. 122-31
(May 2004)
ISSN: 1590-8577 [Electronic] Italy |
PMID | 15138333
(Publication Type: Journal Article, Review)
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Topics |
- Abdominal Pain
(etiology, surgery)
- Acute Disease
- Adolescent
- Adult
- Aged
- Chronic Disease
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Pancreas
(abnormalities, surgery)
- Pancreatitis
(etiology, surgery)
- Postoperative Complications
- Retrospective Studies
- Sphincterotomy, Endoscopic
(adverse effects, methods)
- Stents
- Treatment Outcome
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