What is the best surgery for pancreas divisum?

Lu et al found evidence that endoscopic retrograde cholangiopancreatography (ERCP) is a safe and effective treatment for symptomatic pancreas divisum, with no significant differences between underaged (age ≤17 years) and adult (age ≥18 years) groups in procedures, complications, or long-term follow-up results.

How is pancreatic Divisum treated?

Unless you have symptoms, pancreas divisum does not require treatment. However, if you have symptoms, you can discuss different treatment options with your doctor. The treatment is typically endoscopic retrograde cholangiopancreatography (ERCP) with minor papilla sphincterotomy.

How is pancreatic Divisum diagnosed?

The most common way to diagnose pancreas divisum is with magnetic resonance cholangiopancreatography (MRCP). Other methods of diagnosis include: Endoscopic Retrograde Cholangiopancreatography (ERCP) Computed tomography (CT scan)

Is pancreatic Divisum curable?

Pancreas divisum without symptoms needs no treatment. Treatment of patients with abdominal pain and recurrent pancreatitis attributable to pancreas divisum has not been well established. Some doctors will attempt sphincterotomy (cutting of the minor papilla during ERCP to enlarge its opening).

Is pancreatic Divisum normal?

Pancreas divisum is the most common birth defect of the pancreas. In many cases, this defect goes undetected and causes no problems. The cause of the defect is unknown. As a baby develops in the womb, two separate pieces of tissue join together to form the pancreas.

Is pancreatic Divisum painful?

Pancreas divisum can lead to recurrent or acute pancreatitis, which is painful and can lead to malnutrition. It occurs when the narrow pancreatic duct becomes blocked as the digestive juices find it difficult to drain into the small intestine. This causes swelling and damage to the tissue.

Are you born with pancreatic Divisum?

Pancreas divisum is the most common anomaly of the pancreas that is present from birth. Normally, all human embryos start life with the pancreas in two parts, each with its own duct — the ventral duct and the dorsal duct. During development, these two parts usually fuse, and the two ducts also fuse to make one duct.

Is pancreatic Divisum rare?

The most common presentation would be episodes of acute or recurrent pancreatitis or, in rare cases, symptoms of chronic pancreatitis. Pancreas divisum is a very common congenital anomaly of the pancreatic ductal system, where there is a nonfusion of the dorsal and ventral ducts of the pancreas embryologically.

What effects on digestion do you expect to see in a person with pancreas divisum who develops pancreatitis?

What is the role of ERCP in the workup of pancreatitis?

In patients with recurrent acute or chronic pancreatitis, ERCP may detect common bile duct stones or duct narrowing not seen by other imaging modalities, focal narrowing of the pancreatic duct (termed a stricture), other manifestations of chronic pancreatitis suggesting that surgery may be of benefit (e.g. duct dilation), or evidence of a tumor.

What is a reverse pancreas divisum?

A reverse pancreas divisum has been described where the main duct fuses with the ventral duct and a small residue dorsal duct does not communicate with the main duct and drains separately into the minor papilla 9,10.

Can secretin MRCP (s-MRCP) detect pancreas divisum?

the ventral duct (duct of Wirsung), which does not communicate with the dorsal duct but joins with the distal bile duct to enter the major papilla Some authors claim increased sensitivity of secretin MRCP (S-MRCP) in detection of pancreas divisum 2.

What is the pathophysiology of pancreas divisum?

Most people with a pancreas divisum are asymptomatic, but this is more frequently found in patients with chronic abdominal pain and idiopathic pancreatitis than in the general population 4. Pathology. It results from failure of fusion of dorsal and ventral pancreatic anlages.