Abstract
Background
Acute recurrent pancreatitis (ARP) is a rare manifestation of Intraductal Papillary
Mucinous Neoplasms (IPMN) of the pancreas; ARP is a relative indication for pancreatic
surgery in the setting of IPMN. Endoscopic pancreatic sphincterotomy (EPS) has been
described as a minimal invasive treatment to reduce the episodes of ARP secondary
to mucus migration in IPMN.
Methods
patients with IPMN-related ARP treated with ESP from January 2004 to December 2020
were retrospectively selected. Clinical and technical data were recorded. A clinical
follow-up (minimum 12 months) was performed to assess the number of episodes of AP
occurring after EPS.
Results
25 patients were included. The mean follow-up after ESP was 93.4 months (SD± 56.6).
The mean number of AP before and after EPS were respectively 3.29 (SD ± 1.04) and
0.51 (SD ± 0.71). A complete response (no further episodes of AP) and a partial response
(>50% reduction of AP episodes) were obtained in 64% and 24% of the cases, respectively,
with an overall response rate of 88%. One post-EPS bleeding and one minor-papilla
stenosis were reported and were endoscopically managed. Two patients underwent pancreatic
resection for the occurrence of high-risk stigmata for cancer progression.
Conclusions
EPS is a safe and effective treatment to reduce the number of episodes of AP in selected
patients with IPMNs-related ARP. Prospective trials are needed to confirm these data.
Keywords
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Article info
Publication history
Published online: November 08, 2022
Accepted:
October 13,
2022
Received:
June 14,
2022
Identification
Copyright
© 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
