Annals of gastroenterology · 2024
Meandering main pancreatic duct syndrome: a single-center cohort study and aggregated review.
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Adam Timothy, Malenstein Hannah Van, Laleman Wim
Аннотация
BACKGROUND: Meandering main pancreatic duct (MMPD) refers to an uncommon ductal variant of the normal smooth curvilinear course of the pancreatic duct. More specifically, MMPD is characterized by a hairpin (reverse Z-type) or loop (loop-type) turn in the pancreatic head. It has been suggested as a predisposing factor for the development of pancreatitis. Studies regarding treatment are scarce.
METHODS: We conducted a narrative review of the current literature regarding MMPD. Additionally, we present a cohort of 9 symptomatic patients treated endoscopically at our tertiary center.
RESULTS: Seven retrospective cohort studies and 4 case reports were included in our review. Only 1 study focuses on the clinical significance of MMPD and describes a positive association between MMPD and the onset of pancreatitis, especially recurrent acute pancreatitis. Only 1 case reports an endoscopic treatment. In our cohort of 9 MMPD patients, 7 did indeed present with recurrent acute pancreatitis. Endotherapy provided substantial regression of symptoms in 6 patients, all of whom had signs of ductal hypertension.
CONCLUSIONS: Our review shows the scarcity of data regarding MMPD, especially concerning treatment, in the current literature. With our cohort, we not only hope to raise awareness of this often-neglected entity of recurrent acute pancreatitis, but also support the case for endotherapy for the first time in 9 symptomatic MMPD patients, especially in the presence of ductal hypertension.
METHODS: We conducted a narrative review of the current literature regarding MMPD. Additionally, we present a cohort of 9 symptomatic patients treated endoscopically at our tertiary center.
RESULTS: Seven retrospective cohort studies and 4 case reports were included in our review. Only 1 study focuses on the clinical significance of MMPD and describes a positive association between MMPD and the onset of pancreatitis, especially recurrent acute pancreatitis. Only 1 case reports an endoscopic treatment. In our cohort of 9 MMPD patients, 7 did indeed present with recurrent acute pancreatitis. Endotherapy provided substantial regression of symptoms in 6 patients, all of whom had signs of ductal hypertension.
CONCLUSIONS: Our review shows the scarcity of data regarding MMPD, especially concerning treatment, in the current literature. With our cohort, we not only hope to raise awareness of this often-neglected entity of recurrent acute pancreatitis, but also support the case for endotherapy for the first time in 9 symptomatic MMPD patients, especially in the presence of ductal hypertension.