Endoscopy 2019; 51(04): S147
DOI: 10.1055/s-0039-1681602
ESGE Days 2019 ePoster podium presentations
Friday, April 5, 2019 13:30 – 14:00: ERCP pancreas 2 ePoster Podium 4
Georg Thieme Verlag KG Stuttgart · New York

PANCREAS DIVISUM AND RECURRENT PANCREATITIS: LONG-TERM RESULTS OF MINOR PAPILLA SPHINCTEROTOMY

T Schepis
1   Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS., Rome, Italy
,
A Tringali
2   Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS. Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training – CERTT, Rome, Italy
,
T Voiosu
3   Gastroenterology Department, Colentina Clinical Hospital, Bucharest, Romania
,
R Landi
2   Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS. Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training – CERTT, Rome, Italy
,
V Perri
2   Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS. Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training – CERTT, Rome, Italy
,
I Boškoski
2   Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS. Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training – CERTT, Rome, Italy
,
V Bove
2   Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS. Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training – CERTT, Rome, Italy
,
G Costamagna
2   Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS. Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training – CERTT, Rome, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Pancreas divisum (PD) is the most common congenital anatomical variant of the pancreatic ductal system and a potential cause of acute recurrent pancreatitis (ARP) in a minority of patients. Endoscopic therapy has been studied as a therapeutic option for symptomatic PD, but there is limited long-term data on efficacy and safety of this method. We aimed to assess the technical success and clinical benefit of minor papilla endoscopic sphincterotomy (MiES) in the setting of ARP in patients with PD.

Methods:

We conducted a retrospective study of prospectively collected data of consecutive patients treated by minor papilla endoscopic sphincterotomy (MiES) at a tertiary referral center. Clinical data, including gender, age, smoking and drinking habits, number of episodes of acute pancreatitis (AP) as well as technical data pertaining to the endoscopic therapy were reviewed. Patients available for follow-up were contacted to assess the long-term impact of the endoscopic intervention using the Patient's Global Impression of Change (PGIC) questionnaire.

Results:

A total of 138 patients with PD including 77 patients with ARP, were treated endoscopically by MiES; 48 patients were available for long-term follow-up using the PGIC score, with a mean follow-up period of 9.7 years. Procedure-related complications developed in 10 cases (12.9%): 5 post-MiES delayed bleeding and 5 cases of mild pancreatitis. MiES was clinically succesful in 35 patients (72.9%) who did not experience any more episodes of AP after the initial endoscopic treatment. Significant or very significant improvement in quality of life assessed by the patient at follow-up (PGIC ≥6) occured in 41/48 patients (85.4%). On multivariate analysis, stenosis of the MiES was the only predictive factor for increased risk of recurrent pancreatitis after initial therapy.

Conclusions:

MiES resulted a safe and efficient treatment for ARP in patients with PD, with clinical benefit even at long-term follow-up.