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Pancreas Divisum and Minor Papilla Interventions

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Advanced Pancreaticobiliary Endoscopy

Abstract

Pancreas divisum is the most common congenital anomaly of the pancreas. Defined in its classic form by absence of fusion of the dorsal and ventral pancreatic ducts, pancreas divisum has been associated with pancreatitis. Despite this association, its clinical relevance remains uncertain. Endoscopic therapies aimed at improving dorsal pancreatic duct drainage have improved over the years, although its role in the treatment of patients with chronic pancreatitis and chronic abdominal pain, however, is much less established. A randomized, large multi-center, prospective therapeutic trial of endotherapy in symptomatic patients with pancreas divisum is much needed. For now, the risk-benefit ratio of performing ERCP with possible therapeutic intervention needs to be thoroughly reviewed with the patient and care team.

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Author information

Authors and Affiliations

  1. Clinical and Research Fellow, Gastrointestinal Unit, Massachusetts General Hospital, Boston, MA, USA

    Jay Luther M.D.

  2. Interventional Gastroenterology, Endoscopic Training, Harvard Medical School, Blake 453D, 55 Fruit Street, Boston, MA, 02114, USA

    Brenna W. Casey M.D., F.A.S.G.E.

Authors
  1. Jay Luther M.D.
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  2. Brenna W. Casey M.D., F.A.S.G.E.
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Corresponding author

Correspondence to Brenna W. Casey M.D., F.A.S.G.E. .

Editor information

Editors and Affiliations

  1. Salt Lake City, Utah, USA

    Douglas G. Adler

Video Legend

Minor papilla intervention. A gentleman with presumed alcohol pancreatitis underwent ERCP for endoscopic intervention of a pancreatic duct stricture visualized on cross-sectional imaging. However, pancreatogram revealed the presence of pancreas divisum. Given this, minor papilla sphincterotomy and duct placement were performed (WMV 16743 kb).

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© 2016 Springer International Publishing Switzerland

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Luther, J., Casey, B.W. (2016). Pancreas Divisum and Minor Papilla Interventions. In: Adler, D. (eds) Advanced Pancreaticobiliary Endoscopy. Springer, Cham. https://doi.org/10.1007/978-3-319-26854-5_9

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  • DOI: https://doi.org/10.1007/978-3-319-26854-5_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-26852-1

  • Online ISBN: 978-3-319-26854-5

  • eBook Packages: MedicineMedicine (R0)

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