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| Diagnosis and treatment of pancreas divisum: A literature review |
| Valentina Ferri ∗, Emilio Vicente, Yolanda Quijano, Benedetto Ielpo, Hipolito Duran, Eduardo Diaz, Isabel Fabra, Riccardo Caruso |
Division of General Surgery, Sanchinarro Hospital, San Pablo University, calle oña 10, 28050 Madrid, Spain
∗ Corresponding author.
E-mail address: Valenpeglio@gmail.com (V. Ferri). |
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Abstract Background: Pancreas divisum is a congenital embryological disease caused by a lack of fusion between the ventral and dorsal pancreatic ducts in the early stages of embryogenesis. Recurrent acute pancreatitis, chronic pancreatitis or chronic abdominal pain are the main clinical syndromes at presentation and occur in only 5% of the patients with pancreas divisum. This review aimed to discuss diagnosis and treatment strategies in patients with symptomatic pancreas divisum.
Data sources: We report a literature review from 1990 up to January 2018 to explore the various di- agnostic modalities and surgical techniques and results reported in the surgical treatment of pancreas divisum.
Results: There are limited reports available on this topic in the literature. We analyzed and described the main indications in the treatment of pancreas divisum, focusing on surgical treatment and a discussion of the different approaches. Furthermore, we report the results from our experience in two cases of pancreas divisum treated by pancreatic head resection with segmental duodenectomy (the Nakao procedure).
Conclusions: Pancreas divisum is a common pancreatic malformation in which only a few patients de- velop a symptomatic disease. Surgical treatment is needed in case of endoscopic drainage failure and in cases complicated with chronic pancreatitis and local complications. Many techniques, of greater or lesser complexity, have been proposed.
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2019, Vol. 18 
