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For decades, the performance of minor papilla endoscopic sphincterotomy (MiES) in patients with pancreas divisum has been debated, and opponents cite the lack of high-quality data on safety and efficacy. Now, clinicians in Italy have reported their 25-year experience with MiES, presenting data on 77 patients with pancreas divisum who underwent MiES for acute recurrent pancreatitis.
Most patients underwent MiES with standard sphincterotomy, but 8% underwent needle-knife sphincterotomy. Initial cannulation failure rate was 14%, but reattempts were successful in all patients. Ten patients developed adverse events, five each with bleeding and pancreatitis.
Long-term outcome data were available for 48 patients (mean follow-up period, 10 years). Cl…