Clinical Research Papers:
Endoscopic therapy for patients with pancreaticobiliary maljunction: a follow-up study
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Zheng Jin1,2,*, Li-Ke Bie1,*, Yan-Ping Tang2,*, Liang Ge3, Si-Si Shen4, Bin Xu1, Tao Li1 and Biao Gong1
1 Department of Gastroenterology, Digestive Endoscopy Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
2 First People’s Hospital of Hangzhou, Hangzhou, Zhejiang, China
3 Department of Gastroenterology, Shihezi People’s Hospital, Shihezi, China
4 The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
* These authors have contributed equally to this work
Biao Gong, email:
Keywords: pancreas divisum, endoscopic retrograde cholangiopancreatography, endoscopic pancreatic sphincterotomy, endoscopic nasopancreatic drainage, endoscopic retrograde pancreatic drainage
Received: October 13, 2016 Accepted: March 07, 2017 Published: March 15, 2017
Background: Data on the experience of endoscopic retrograde cholangiopancreatography (ERCP) in the management of pancreaticobiliary maljunction (PBM) is limited.
Methods: A retrospective review of patients with PBM who underwent therapeutic ERCP at our endoscopy center between January 2008 and January 2016 was performed. Demographic, clinical, radiological and endoscopic data was documented. Patients who underwent sphincterotomy were divided into dilated group and undilated group based on their common channel diameter.
Results: Sixty-three PBM patients underwent 74 ERCP procedures. The technical success rate was 97.3%. ERCP therapy significantly decreased the levels of elevated liver enzymes and bilirubin. After an average of 27 months follow-up, 7 patients (11.1%) were lost. The overall effective rate of ERCP therapy was 60.7% (34/56). Decline in severity and frequency of abdominal pain was significant. Procedure-related complications were observed in 5 (6.8%) cases. Between the dilated group and undilated group, no significant difference was observed in effective rate, adverse events and follow-up results.
Conclusions: ERCP can serve as a transitional step to stabilize PBM patients before definitive surgery. PBM patients with undilated common channel could benefit from sphincterotomy as well as those with dilated common channel.
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