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A systematic review and quantitative analysis of different therapies for pancreas divisum

Mohammadreza Hafezi, Bartosch Mayschak, Pascal Probst, Markus W B├╝chler, Thilo Hackert, Arianeb Mehrabi
American Journal of Surgery 2017, 214 (3): 525-537

BACKGROUND: Pancreas divisum is the most common anatomical variation of pancreatic ductal system affecting 5-10% of population. Therapy includes different endoscopic and surgical procedures. The aim of this article was to summarize actual evidence of different treatment.

METHODS: A Medline search was performed to identify all studies, investigating endoscopic or surgical therapy of Pancreas divisum. An individual data simulation model was applied to compare endoscopic and surgical studies.

RESULT: 56 observational studies (31 endoscopic and 25 surgical studies) were included in analyses. Surgery was significantly superior to endoscopic treatment in terms of success rate (72% vs. 62.3), complication rate (23.8% vs. 31.3%) and re-intervention rate (14.4% vs. 28.3%).

CONCLUSION: Surgery may be superior to endoscopy in terms of treatment success and complications. There is no study comparing these two therapies. Consequently, a randomized trial is needed to clarify if endoscopy or surgery is superior in the therapy of pancreas divisum.

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