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Endoscopic stenting and sphincterotomy of the minor papilla in symptomatic pancreas divisum: results and complications.
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MedLine Citation:
PMID:  18493355     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Pancreas divisum has been postulated as a cause of acute pancreatitis and a chronic pain syndrome in a small subgroup of patients and can be treated with endoscopic dorsal pancreatic duct stent placement and minor papilla sphincterotomy. Twenty patients (9 with at least one attack of idiopathic pancreatitis, and 11 with severe pancreatic-type pain) were treated endoscopically. Dorsal duct stents were placed in 19 patients with subsequent needle knife sphincterotomy of the minor papilla over the stent. Clinical response was judged by comparison of symptoms (using a 0-to-l0 scale and the patient's overall assessment). The symptom score improved from 9.3 to 5.1 in the pancreatitis group and from 9.3 to 5.7 in the pain group. A good clinical response was observed in 3 of 7 patients in the pancreatitis group and in 6 of 11 in the pain group at a mean follow-up of 22 months. Complications of sphincterotomy were limited to pancreatitis in 6 patients (29%), 5 mild and 1 moderate according to published criteria. No patient required more than 4 days hospitalization. Two of 39 stents migrated into the pancreas, and another stent fractured and remained lodged in the pancreas. Eight of 9 patients evaluated demonstrated new morphologic duct changes on follow-up pancreatograms. Endoscopic stenting and sphincterotomy of the minor papilla are feasible and may be effective in some patients with pancreas divisum but carries a significant complication rate. The subjective improvement in patients with chronic pain warrants further controlled study.
Authors:
S A Cohen; F D Rutkovsky; J H Siegel; F E Kasmin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diagnostic and therapeutic endoscopy     Volume:  1     ISSN:  1070-3608     ISO Abbreviation:  Diagn Ther Endosc     Publication Date:  1995  
Date Detail:
Created Date:  2008-05-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9502019     Medline TA:  Diagn Ther Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  131-9     Citation Subset:  -    
Affiliation:
Section of Endoscopy Beth Israel Medical Center North Division New York New York USA.
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Journal Information
Journal ID (nlm-ta): Diagn Ther Endosc
ISSN: 1070-3608
ISSN: 1029-0516
Publisher: Hindawi Publishing Corporation
Article Information
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Copyright ? 1995 Hindawi Publishing Corporation.
open-access: This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received Day: 27 Month: 1 Year: 1994
Accepted Day: 4 Month: 4 Year: 1994
Print publication date: Year: 1995
Volume: 1 Issue: 3
First Page: 131 Last Page: 139
ID: 2362478
PubMed Id: 18493355
Publisher Item Identifier: S1070360895000038
DOI: 10.1155/DTE.1.131

Endoscopic Stenting and Sphincterotomy of the Minor Papilla in Symptomatic Pancreas Divisum: Results and Complications
Seth A. Cohen1
Frederick D. Rutkovsky1
Jerome H. Siegel12
Franklin E. Kasmin1
1Section of EndoscopyBeth Israel Medical CenterNorth DivisionNew YorkNew YorkUSA
260 East End AvenueNew YorkNY10028USA


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