A systematic review and quantitative analysis of different therapies for pancreas divisum

Am J Surg. 2017 Sep;214(3):525-537. doi: 10.1016/j.amjsurg.2016.12.025. Epub 2017 Jan 3.

Abstract

Background: Pancreas divisum is the most common anatomical variation of pancreatic ductal system affecting 5-10% of population. Therapy includes different endoscopic and surgical procedures. The aim of this article was to summarize actual evidence of different treatment.

Methods: A Medline search was performed to identify all studies, investigating endoscopic or surgical therapy of Pancreas divisum. An individual data simulation model was applied to compare endoscopic and surgical studies.

Result: 56 observational studies (31 endoscopic and 25 surgical studies) were included in analyses. Surgery was significantly superior to endoscopic treatment in terms of success rate (72% vs. 62.3), complication rate (23.8% vs. 31.3%) and re-intervention rate (14.4% vs. 28.3%).

Conclusion: Surgery may be superior to endoscopy in terms of treatment success and complications. There is no study comparing these two therapies. Consequently, a randomized trial is needed to clarify if endoscopy or surgery is superior in the therapy of pancreas divisum.

Keywords: Pancreas divisum; Pancreas/surgery; Surgical and endoscopic treatment.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Anatomic Variation
  • Evaluation Studies as Topic
  • Humans
  • Pancreas / abnormalities*
  • Pancreas / surgery*
  • Treatment Outcome