Pancreas Divisum

Objective: To evaluate the complications, technical success, diagnostic evaluation and various endoscopic management options in patients with pancreas divisum. Study Design: Descriptive study. Place and Duration of Study: Endoscopy Suite, Surgical Unit 4, Civil Hospital, Karachi, from January 2007 to December 2013. Methodology: All Endoscopic Retrograde Cholangio-pancreatography (ERCPs) procedure performed in patients with pancreas divisum were analyzed. Success was defined as having authentic diagnostic information or a successful endoscopic therapy for the condition. Results: During the study period, 3600 patients underwent 4500 ERCP procedures. Pancreas divisum was found in 17 patients (0.47 percentage); 7 ERCPs (41.2 percentage) were performed for diagnostic and 10 (58.8 percentage) for therapeutic purposes. Sixteen (94.1 percentage) had complete PD and one (5.9 percentage) had incomplete PD. Male and Female ratio was 1:1.83 with a mean age of 26.3 years and median symptom duration of 11 months. A total of 23 procedures were performed in 17 patients; 2 had ERCPdone thrice, 2 underwent the procedure twice, while the rest had single procedure done. Six (35.3 percentage) patients had chronic pancreatitis, 7 (41.2 percentage) had acute recurrent pancreatitis and 4 (23.5 percentage) had acute pancreatitis. Endoscopic minor papillotomy was performed. There was no procedure-related mortality. ERCP affected management in 88.2 percentage (15/17 procedures). Conclusion: ERCP is a safe and feasible procedure for pancreas divisum patients. (author)