Jacob L, Geenen J E, Catalano M F, Johnson G K, Geenen D J, Hogan W J
Pancreatic Biliary Center, St. Luke's Medical Center, Milwaukee, Wisconsin, USA.
Gastrointest Endosc. 1999 Jan;49(1):53-7. doi: 10.1016/s0016-5107(99)70445-1.
The clinical significance of incomplete pancreas divisum (IPD) has not been fully described. In this study we report the clinical presentation and results of endoscopic treatment of the 32 (0.6%) patients with IPD seen at our center over a 10-year period.
The study population consisted of 24 women and 8 men (mean age 42 years, range 13 to 82 years). Ten (31%) patients presented with acute recurrent pancreatitis, 5 (16%) with chronic pancreatitis, and 3 (9%) with pancreatic type pain. Detailed history, laboratory tests, US, CT, and ERCP excluded other etiologies for their symptoms. The remaining 14 (44%) presented with biliary problems. The 18 symptomatic patients with IPD were treated as follows: 8 received dorsal duct stents, 3 underwent minor papilla endoscopic sphincterotomy and dorsal duct stent placement, 4 had minor papilla dilatation only, and 3 had ventral duct stents placed.
Patients were then followed for recurrence of pancreatitis and pancreatic-type pain. Mean follow-up was 15.5 months (range 3 to 30 months). Six (60%) of the patients with acute recurrent pancreatitis and 4 (80%) with chronic pancreatitis benefitted from the endoscopic therapy. However, only 1 (33%) of the patients with pancreatic-type pain benefitted.
The clinical presentation and response to endoscopic therapy of patients with ICP appeared to be similar to that of patients with complete pancreas divisum.
不完全胰腺分裂（IPD）的临床意义尚未得到充分描述。在本研究中，我们报告了10年间在我们中心就诊的32例（0.6%）IPD患者的临床表现及内镜治疗结果。
研究人群包括24名女性和8名男性（平均年龄42岁，范围13至82岁）。10例（31%）患者表现为急性复发性胰腺炎，5例（16%）为慢性胰腺炎，3例（9%）为胰型疼痛。详细的病史、实验室检查、超声、CT和内镜逆行胰胆管造影（ERCP）排除了导致其症状的其他病因。其余14例（44%）表现为胆道问题。18例有症状的IPD患者接受了如下治疗：8例接受背侧胰管支架置入，3例接受小乳头内镜括约肌切开术及背侧胰管支架置入，4例仅行小乳头扩张，3例接受腹侧胰管支架置入。
随后对患者进行胰腺炎和胰型疼痛复发情况的随访。平均随访时间为15.5个月（范围3至30个月）。6例（60%）急性复发性胰腺炎患者和4例（80%）慢性胰腺炎患者从内镜治疗中获益。然而，只有1例（33%）胰型疼痛患者获益。
IPD患者的临床表现及对内镜治疗的反应似乎与完全胰腺分裂患者相似。
