Common Procedure Does Not Prevent Recurrent Pancreatitis, Trial Finds - News Center

""Pancreas divisum is a causative factor in a subset of patients with recurrent acute pancreatitis, a painful inflammatory condition of the pancreas," Keswani said. "Essentially, in pancreas divisum, the pancreas juice drains predominantly through a small opening in the intestine called the minor papilla. While pancreas divisum occurs in 5-10 percent of people, only a small proportion of people develop pancreatic issues.""

""For patients with pancreas divisum and recurrent pancreatitis, an endoscopy procedure called an ERCP has been utilized to perform an internal incision of the minor papilla to 'improve' the drainage of the pancreas and presumably reduce pancreatitis episodes," he said. "However, despite decades of performing this therapy, its efficacy had never been definitively studied.""

A randomized, multicenter trial across 21 U.S. and Canadian centers compared ERCP with minor papillotomy to a sham procedure in 148 adults with unexplained recurrent acute pancreatitis and pancreas divisum. ERCP with minor papillotomy did not reduce future episodes of acute pancreatitis in these patients. Pancreas divisum is a congenital ductal variant in which pancreatic secretions drain mainly through the minor papilla and occurs in approximately 5–10% of people, while only a small fraction develop pancreatic disease. Endoscopic incision of the minor papilla had been widely used despite lacking randomized evidence of effectiveness.

Read at News Center