Meandering main pancreatic duct syndrome: a single-center cohort study and aggregated review.

IF 2.1 Q3 GASTROENTEROLOGY & HEPATOLOGY
Annals of Gastroenterology Pub Date : 2024-09-01 Epub Date: 2024-07-12 DOI:10.20524/aog.2024.0901
Timothy Adam, Hannah Van Malenstein, Wim Laleman
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引用次数: 0

Abstract

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.

蜿蜒主胰管综合征:一项单中心队列研究和汇总综述。
背景:蜿蜒主胰管(MMPD)是指胰管正常平滑曲线走向的一种不常见的管状变异。更具体地说,MMPD 的特征是胰腺头部出现发夹型(反向 Z 型)或环形(环形)转向。有人认为这是胰腺炎发病的一个诱发因素。有关治疗的研究很少:方法:我们对目前有关 MMPD 的文献进行了叙述性综述。此外,我们还介绍了在我们的三级中心接受内镜治疗的 9 例有症状患者的队列:我们的综述包括 7 项回顾性队列研究和 4 项病例报告。只有 1 项研究关注 MMPD 的临床意义,并描述了 MMPD 与胰腺炎(尤其是复发性急性胰腺炎)发病之间的正相关性。只有 1 例报告了内镜治疗。在我们的 9 例 MMPD 患者中,有 7 例确实出现了复发性急性胰腺炎。内镜治疗使 6 名患者的症状得到了实质性缓解,这些患者都有导管高压的症状:我们的综述表明,目前文献中有关 MMPD 的数据,尤其是有关治疗的数据非常稀少。通过我们的队列,我们不仅希望提高人们对这一经常被忽视的复发性急性胰腺炎实体的认识,还首次支持对 9 例有症状的 MMPD 患者进行内科治疗,尤其是在存在导管高压的情况下。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Gastroenterology
Annals of Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
4.30
自引率
0.00%
发文量
58
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