Surgical sphincteroplasty of the minor papilla for the treatment of recurrent pancreatitis due to pancreas divisum

Abstract

Background: pancreas divisum (PD) is a common congenital variant, which occurs due to incomplete fusion of the dorsal and ventral pancreatic ducts during embryogenesis.
Objective: report of two cases of surgically treated PD and review of the literature.
Method: we describe the clinical presentation of 2 patients with symptomatic PD, who underwent surgical sphincteroplasty of the minor papilla. 
Results: both cases underwent surgical sphincteroplasty of the minor papila without complications in the immediate course. On follow up at 12 and 14 months respectively, one patient had two admissions due to abdominal pain, managed conservatively. The other patient presented with stenosis of the duodenorrhaphy with good results after endoscopic dilation.
Conclusions: surgical sphincteroplasty should be indicated in patients with recurrent acute pancreatitis without structural changes in the pancreas, in which endoscopic treatment has failed