Long Term Outcome of Endoscopic Minor Papillotomy in Patients with Symptomatic Pancreas Divisum: Experience from Northern India

Pancreas divisum (PD) occurs due to the non-union of dorsal and ventral pancreatic ducts during organogenesis and is the most common developmental anatomic variant of pancreatic duct. Most of the PD cases remain asymptomatic, while others may present with recurrent/chronic abdominal pain. PD is considered an important cause of idiopathic recurrent acute pancreatitis. The diagnosis of PD is challenging and is often delayed. Failure to detect PD may lead to recurrent episodes of pancreatitis and development of chronic pancreatitis. Timely papillotomy of the minor papilla alleviates symptoms in majority of these patients. There is paucity of data on symptomatic pancreas divisum from India. We report a case series of seven patients with symptomatic pancreas divisum, 71.4% of these were females and 57.1% presented with recurrent acute pancreatitis. All the patients had long term symptomatic improvement after endoscopic papillotomy of minor papilla.