| Long-term clinical outcomes after endoscopic minor papilla therapy in symptomatic patients with pancreas divisum. | |
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MedLine Citation:
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PMID: 19672208 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To assess the long-term outcomes of endoscopic minor papilla therapy in a spectrum of symptomatic patients with pancreas divisum. METHODS: Patients with pancreas divisum coded in a prospective database as having had minor papilla endotherapy (July 1997-May 2003, n = 145) were grouped into 3 categories: (1) acute recurrent pancreatitis, (2) chronic pancreatitis, and (3) chronic/recurrent epigastric pain. Telephone follow-up was conducted (78% of patients), including questions regarding interval co-interventions and narcotic use. Primary success was defined as clinical improvement (better or cured on a Likert scale), without needing narcotics, after 1 therapeutic endoscopic retrograde cholangiopancreatography. Fisher exact and Mann-Whitney U tests and multivariate logistic regression were used to identify predictors of success. RESULTS: Primary success rates in acute recurrent pancreatitis, chronic pancreatitis, and chronic/recurrent epigastric pain were achieved in 53.2%, 18.2%, and 41.4%, respectively; and secondary success rates (<or=2 additional endoscopic retrograde cholangiopancreatographies), 71.0%, 45.5%, and 55.2%, respectively (median follow-up, 43.0 months; range, 14-116 months). Younger age (median age, 46.5 years [no success] vs 58.0 years [success]; P < 0.0001) and chronic pancreatitis (odds ratio, 0.10; 95% confidence interval, 0.03-0.39; P = 0.001) independently predicted a lower chance of success. CONCLUSIONS: Significant long-term improvement can be achieved with endoscopic therapy in selected patients with pancreas divisum, although many require multiple procedures. Older patients, without chronic pancreatitis, were most likely to respond. |
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Authors:
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Gregory D Borak; Joseph Romagnuolo; Mohammad Alsolaiman; Edward W Holt; Peter B Cotton |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Pancreas Volume: 38 ISSN: 1536-4828 ISO Abbreviation: Pancreas Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2009-10-26 Completed Date: 2010-02-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8608542 Medline TA: Pancreas Country: United States |
Other Details:
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Languages: eng Pagination: 903-6 Citation Subset: IM |
Affiliation:
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Division of Gastroenterology and Hepatology, Digestive Disease Center, Medical University of South Carolina, Charleston, SC 29425, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abdominal Pain
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surgery Acute Disease Adult Aged Cholangiopancreatography, Endoscopic Retrograde / methods* Female Follow-Up Studies Humans Logistic Models Male Middle Aged Multivariate Analysis Outcome Assessment (Health Care) / methods, statistics & numerical data Pancreas / abnormalities*, surgery* Pancreatitis / surgery Pancreatitis, Chronic / surgery Recurrence Time Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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