3570 Children/adolescents with pancreas divisum and recurrent pancreatitis - endoscopic therapy is safe and efficient.

Abstract

In patients with recurrent pancreatitis during childhood an important cause to be excluded is pancreas divisum, as this can be treated with to sphincterotomy of the minor papilla. Method: During the periode 10/96 to 10/99, 5 children/adolescents (age 3 to 18, median 8,2) with previous diagnosis of pancreas divisum and acute pancreatitis recurring at short intervalls were presented for endoscopic intervention. In all cases this was performed under full anesthetic using a standard duodenoscope (Olympus JF100). After visualizing the minor papilla, a pre-cut guide wire papillotome was attached. As primary probing with guide wire (hydrophile, 0,035cm) was impossible, the papillary ostium was opened slowly with repeated attempts to steer along the guiding wire. After few attempts the pre-cut papillotome could be inserted deep enough into the duct to permit a safe performance of sphincterotomy. Finally, a 9cm 7F plastic stent was inserted for a period of 6 weeks. Results: Safe and speedy sphincterotomy of the minor papilla was successfully performed in all cases. Complications were not observed. During the follow-up period (2.5 to 3.5 years) no recurrence of pancreatitis was observed. Conclusion: Sphincterotomy of the minor papilla using a pre-cut guide wire papillotome appears to be a safe and efficient interventional method to open the minor papilla in cases of patients with pancreas divisum and recurrent pancreatitis, even in young patients.