A CASE OF PANCREAS DIVISUM UNDERGOING DUODENUM-PRESERVING PANCREAS HEAD RESECTION

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  • 十二指腸温存膵頭切除術を施行した膵管癒合不全の１例

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Abstract

A 23-year-old man, who had suffered repeated episodes of acute pancreatitis since 2001 and had been treated by a doctor, was referred to our Department of Gastroenterology with suspected pancreas divisum by ERCP in 2003. He was followed after symptomatic improvement by fasting. Abdominal pain recurred in November 2004, and he was referred again with severe dilatation of the main pancreatic duct of the pancreas body and tail, and calcification of the pancreas head by MRCP & abdominal CT scan at another hospital. The ventral pancreatic duct curved and was occluded halfway by ERP from the major papilla. ERP from the minor papilla was unsuccessful and he consulted us because of difficult endoscopic therapy. Duodenum-preserving pancreas head resection was performed on February 4, 2005. Fibrous overgrowth was observed in the ventral and dorsal pancreas, therefore, the histopathological diagnosis was chronic pancreatitis with pancreas divisum. He was discharged on postoperative day 37 after temporary duodenal obstruction. Duodenum-preserving pancreas head resection is a good indication for the treatment of pancreas divisum with chronic inflammation of ventral and dorsal parts.

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