ENDOSCOPIC TREATMENT IN PANCREAS DIVISUM

Objectives: We have reviewed the results of endoscopic stenting with a nd without sphincterotomy at the minor papilla in 34 patients with pan creas divisum and pain or pancreatitis. Methods: Symptoms before and a fter the procedure were scored and compared, as was the patient's esti mate of the overall effectiveness of the treatment. Results: A statist ically significant improvement in pain score was found in patients wit h acute recurrent pancreatitis and in patients with chronic pancreatit is, but not in a small group of patients suffering pain without pancre atitis. The overall effectiveness was found to be 78%, 60%, and 40%, r espectively, for these three groups. Complications of treatment were c ommon, but usually mild. There were no evident differences in outcomes between patients who did or did not undergo sphincterotomy of the min or papilla. Conclusions: This study confirms that there is a subgroup of patients with symptomatic pancreas divisum who improve with endosco pic treatment. Correctly identifying these individuals remains a chall enge.