Minor Papillotomy for Treatment of Idiopathic Acute Pancreatitis With Pancreas Divisum

Does endoscopic retrograde cholangiopancreatography (ERCP) with minor papillotomy reduce the risk of acute pancreatitis in patients with unexplained acute recurrent pancreatitis and pancreas divisum anatomy?In this randomized trial including 148 individuals with unexplained acute recurrent pancreatitis and pancreas divisum followed up for a median of 34 months, ERCP with minor papillotomy did not significantly reduce the rate of acute pancreatitis during follow-up (34.7% vs 43.8% for sham ERCP; adjusted hazard ratio, 0.83 [95% CI, 0.49-1.41]). There was no between-group difference in acute pancreatitis episode frequency and development of chronic calcific pancreatitis, diabetes, or exocrine pancreatic dysfunction.Among patients with unexplained acute recurrent pancreatitis and pancreas divisum, ERCP with minor papillotomy does not reduce the risk of another episode of acute pancreatitis or related sequelae.

Corresponding Author: Gregory A. Coté, MD, MS, Division of Gastroenterology and Hepatology, Oregon Health coteg@ohsu.edu).

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