Pancreas divisum. Diagnosis, clinical significance, and management alternatives.

Pancreas divisum patients make up a small but problematic portion of ERCP cases. Minor papilla cannulation techniques have been refined. Recurrent pancreatitis patients generally will benefit from minor papilla therapy. Methods to select patients who are likely to respond to invasive therapy and further study need validation. Clinicians and endoscopists are strongly encouraged to be cautious and conservative with this patient group until stronger data indicate optimal management schemes.