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Annular pancreas: endoscopic and pancreatographic findings from a tertiary referral ERCP center.

Abstract：

BACKGROUND AND AIMS:Annular pancreas is a congenital anomaly whereby pancreatic tissue encircles the duodenum. Current knowledge of endoscopic findings of annular pancreas is limited to small case series. The aim of this study was to describe the endoscopic and pancreatographic findings of patients with annular pancreas at a large tertiary care ERCP center. METHODS:This is a retrospective observational study. Our Institutional Review Board-approved, prospectively collected ERCP database was queried for cases of annular pancreas. The electronic medical records were searched for patient and procedure-related data. RESULTS:From January 1, 1994, to December 31, 2016, 46 patients with annular pancreas underwent ERCP at our institution. Index ERCP was technically successful in 42 patients (91.3%), and technical success was achieved in all 46 patients (100%) after 2 attempts, when required. A duodenal narrowing or ring was found in most patients (n = 39, 84.8%), yet only 2 (4.3%) had retained gastric contents. Pancreas divisum was found in 21 patients (45.7%), 18 of which were complete divisum. Pancreatobiliary neoplasia was the indication for ERCP in 7 patients (15.2%). Pancreatographic findings consistent with chronic pancreatitis were noted in 15 patients (32.6%) at the index ERCP. CONCLUSION:This is the largest series describing the endoscopic and pancreatographic findings of patients with annular pancreas. We found that 45.7% of patients had concurrent pancreas divisum. Endoscopic therapy was successful in most patients at our institution after 1 ERCP, and in all patients after a second ERCP. Nearly one-third of patients had findings consistent with chronic pancreatitis at the time of index ERCP. It is unclear whether this may be a feature of the natural history of annular pancreas.

journal_name

Gastrointest Endosc

journal_title

Gastrointestinal endoscopy

authors

Gromski MA,Lehman GA,Zyromski NJ,Watkins JL,El Hajj II,Tan D,McHenry L,Easler JJ,Tirkes T,Sherman S,Fogel EL

doi

10.1016/j.gie.2018.09.008

subject

Has Abstract

pub_date

2019-02-01 00:00:00

pages

322-328

issue

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(18)33034-7

journal_volume

pub_type

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Annular pancreas: endoscopic and pancreatographic findings from a tertiary referral ERCP center.