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ERCP in Other Pancreatic Disorders

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ERCP and EUS

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Abstract

Pancreas divisum (PD) is the most common congenital anomaly of the pancreas. It is more common in the Western world compared to Asia and in most cases, goes undetected, and does not cause illness. However, it has been associated with both acute and chronic pancreatitis. This chapter will explore the factors that may play a role in causing inflammation in patients with PD and what role endoscopic intervention plays in management.

Autoimmune pancreatitis (AIP) can present in a myriad of ways, and it is known now that there are two distinct forms. Accurate diagnosis requires a high degree of suspicion and a good knowledge of symptoms, imaging, serologic, and histologic finding for each form of AIP. This chapter will examine the critical issues involving AIP and the role that ERCP plays in diagnosis and management.

Intraductal papillary mucinous neoplasm (IPMN) is a relatively newly recognized entity first reported by the Japanese. It comes in three forms: main duct (MD), branch duct (BD), and mixed. The main duct form was first described and initially ERCP played a central role in diagnosis. Since then, the role of ERCP in the diagnosis of IPMN has diminished (especially with the more common side-branch form) but ERCP, particularly pancreatoscopy, can still play an important role in the management of patients with MD-IPMN. This chapter will explore the role of ERCP in IPMN.

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Conflict of Interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, 160012, India

    Asst. Prof.Dr. Surinder Singh Rana MD, DM, MAMS, FASGE, FSGEI

  2. University of Central Florida College of Medicine, Florida Hospital Institute for Minimally Invasive Therapy, Center for Interventional Endoscopy, Florida Hospital, 601 E. Rollins St, Orlando, FL 32803, USA

    Prof. Robert H. Hawes MD

Authors
  1. Asst. Prof.Dr. Surinder Singh Rana MD, DM, MAMS, FASGE, FSGEI
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  2. Prof. Robert H. Hawes MD
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Correspondence to Robert H. Hawes MD .

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Editors and Affiliations

  1. Gastroenterology, Hepatology, and Endoscopy, Brigham and Women’s Hospital, Boston, Massachusetts, USA

    Linda S. Lee

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Video Captions

Video 15.1 EUS for diagnosing pancreas divisum. This video shows the body, genu, and head of the pancreas using a radial echoendoscope. The normal nondilated MPD can be seen to the left of the screen diving downward toward the ventral pancreas and major papilla from the body and genu. This excludes PD

Video 15.2 Minor sphincterotomy

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Rana, S., Hawes, R. (2015). ERCP in Other Pancreatic Disorders. In: Lee, L. (eds) ERCP and EUS. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2320-5_15

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