ENDOSCOPIC MINOR PAPILLA SPHINCTEROTOMY IN PATIENTS WITH PANCREAS DIVISUM AND ACUTE RECURRENT PANCREATITIS: A METANALYSIS

Aims Pancreas divisum (PD) is a common congenital variant of the pancreatic ductal system and a potential cause of acute recurrent pancreatitis (ARP). Endoscopic minor papilla sphincterotomy (MiES) is the most common procedure performed in the management of PD-related ARP. The aim of this study is to perform a metanalysis estimating the efficacy and the safety of MiES in the management of patients with PD-related ARP.

Methods A research was performed in Pubmed and Web of science, the studies were reviewed and selected according to inclusion and exclusion criteria. Evaluation of heterogeneity and publication bias was performed, and a random effect model was used to estimate the effect size of each study.

Results 113 articles were selected and reviewed, 13 met the inclusion criteria. All the studies were retrospective with a mean follow-up duration of 45.9 months. A total of 323 patients with PD-related ARP treated with MiES were included in the metanalysis. The clinical success rate of MiES (defined as no further episodes of ARP, reduction of episodes of ARP, or improvement in QoL) was of 75.60% (95%CI, 66%-85%) (Figure 1). Adverse-events occurred in 22.67% of cases (95%CI, 17.20% – 28.60%): acute pancreatitis in 13.67%, bleeding in 3.56%, and other AEs in 3.61% of cases.

Conclusions MiES is a safe and effective treatment in the management of PD-related ARP. The retrospective nature of the studies selected is the main limitations of the present metanalysis. Prospective trials are needed to confirm these data.

Publication History

Article published online:
14 April 2022