P-P19 Incidentally detected Double Duct Sign (InDDuS): a study on the long-term outcomes

Abstract

Abstract Background The long-term outcomes of patients with biliary and pancreatic ductal dilatation (double duct sign-DDS), without a detectable underlying cause, is unclear in the current literature. This study aims to review the five-year outcomes of patients with incidentally detected double duct sign. Methods This is a retrospective study of patients that were found to have DDS between January 2010 to December 2015 at a tertiary referral Hepato-Pancreatico-Biliary unit. Patients were identified from the departmental performance team and cross-checked with the Radiology department. Patients who had malignancy and benign causes of DDS (such as pancreatitis and gallstones) were excluded. Five-year patient outcomes were collected from subsequent MDT outcomes and clinic letters. Results Initial screen identified 108 patients with DDS. Of these, 37 patients (81% female, median age 69 years, range 26-94 years) had no identifiable cause and were analysed. Main presenting complaints were abdominal pain (n = 22), weight loss (n = 9), and asymptomatic (n = 3). Twelve had anaemia, 14 had derange LFTs and 2 patients had elevated serum CA19-9. A median of two (range 0-9) further investigations were performed to determine the underlying cause of DDS (US = 6, CT = 24, MRCP=17, endoscopy=16). Median follow up of 7.2 (range 5-11) years detected no pancreatic or ampullary cancer amongst all patients. Conclusions Results from this study suggests DDS without evidence of malignancy on Magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasound (EUS) have minimal risk of developing pancreatic or ampullary cancer in the next five years. Thus, they can be safely discharged from follow up.