ERCP in the Management of Symptomatic Pancreas Divisum: A Long-term Follow-up Study

Abstract

ObjectivesTo evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) in dealing with pancreas divisum (PD), and discuss whether ERCP in the underaged was different from that of adult.MethodsSymptomatic patients with PD were included, and divided into the underaged and adult group. Patients’ clinical information was viewed, and then they were contacted through telephone and by searching for medical records to get long-term follow-up outcomes.ResultsA total of 141 procedures were performed in 82 patients, of whom 17 were underaged, and 65 were adults. ERCP indications included abdominal pain (39.02%), pancreatitis (12.20%), recurrent pancreatitis (36.59%) and other discomfort (12.20%). Endoscopic interventions included endoscopic pancreatic sphincterotomy in 44.68%, bouginage in 26.95%, pancreatic ductal stones extraction in 19.15%, endoscopic nasopancreatic drainage in 21.99%, and endoscopic retrograde pancreatic drainage in 56.74%. Fourteen (9.93%) patients had pancreatitis, 5 (3.55%) had biliary infection, and 1 (0.71%) had haemorrhage. After a median follow-up of 41 months, the overall response rate was 72.88%.ConclusionsERCP is safe and can achieve good outcomes for symptomatic PD, though multiple procedures may be required; the ERCP details, adverse events and follow-up results had no difference between the underaged and the adult groups. ObjectivesTo evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) in dealing with pancreas divisum (PD), and discuss whether ERCP in the underaged was different from that of adult. To evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) in dealing with pancreas divisum (PD), and discuss whether ERCP in the underaged was different from that of adult. MethodsSymptomatic patients with PD were included, and divided into the underaged and adult group. Patients’ clinical information was viewed, and then they were contacted through telephone and by searching for medical records to get long-term follow-up outcomes. Symptomatic patients with PD were included, and divided into the underaged and adult group. Patients’ clinical information was viewed, and then they were contacted through telephone and by searching for medical records to get long-term follow-up outcomes. ResultsA total of 141 procedures were performed in 82 patients, of whom 17 were underaged, and 65 were adults. ERCP indications included abdominal pain (39.02%), pancreatitis (12.20%), recurrent pancreatitis (36.59%) and other discomfort (12.20%). Endoscopic interventions included endoscopic pancreatic sphincterotomy in 44.68%, bouginage in 26.95%, pancreatic ductal stones extraction in 19.15%, endoscopic nasopancreatic drainage in 21.99%, and endoscopic retrograde pancreatic drainage in 56.74%. Fourteen (9.93%) patients had pancreatitis, 5 (3.55%) had biliary infection, and 1 (0.71%) had haemorrhage. After a median follow-up of 41 months, the overall response rate was 72.88%. A total of 141 procedures were performed in 82 patients, of whom 17 were underaged, and 65 were adults. ERCP indications included abdominal pain (39.02%), pancreatitis (12.20%), recurrent pancreatitis (36.59%) and other discomfort (12.20%). Endoscopic interventions included endoscopic pancreatic sphincterotomy in 44.68%, bouginage in 26.95%, pancreatic ductal stones extraction in 19.15%, endoscopic nasopancreatic drainage in 21.99%, and endoscopic retrograde pancreatic drainage in 56.74%. Fourteen (9.93%) patients had pancreatitis, 5 (3.55%) had biliary infection, and 1 (0.71%) had haemorrhage. After a median follow-up of 41 months, the overall response rate was 72.88%. ConclusionsERCP is safe and can achieve good outcomes for symptomatic PD, though multiple procedures may be required; the ERCP details, adverse events and follow-up results had no difference between the underaged and the adult groups. ERCP is safe and can achieve good outcomes for symptomatic PD, though multiple procedures may be required; the ERCP details, adverse events and follow-up results had no difference between the underaged and the adult groups.