Pancreas divisum: A retrospective review to evaluate the risk of biliary tract neoplasms

Hala Fatima, Marie Malcolm, Stuart Sherman, Evan L. Fogel, Lee Mchenry, James L. Watkins, Thomas J. Howard, Thomas A. Ruffolo, Claudia E. Nugent, Ayman Abdel Aziz Hassan, Glen A. Lehman

Research output: Contribution to journalReview article


Background - Congenital anomalies of the biliary tree are established risk factors for cholangiocarcinoma (CCA). This review was done to assess the association of pancreas divisum (PD) with biliary tract neoplasms. Methods - A retrospective review of prospectively collected, computer data of all patients who had undergone endoscopic retrograde cholangiopancreatography (ERCP) at the Indiana University Hospital (IUH). Results - A total of 10,339 ERCPs were performed on 7,809 patients between 1994 to 2001. Out of these, 5,570 patients underwent pancreatograms. The remaining were excluded from the review. Of the total sampled patients 875 (15.7%) had pancreas divisum. Out of all the ERCPs in both patients with or without divisum, a total of 73 cholangiocarcinomas, 46 ampullary carcinomas (ACA) and 42 ampullary adenomas were found. Of the total 73 CCA, 10 had PD (13.7%), of the 46 ACA, 8 had PD (17.4%), and of the total number of biliary tract malignancies, 18 had PD (15.1%). These figures did not differ significantly when compared to the number of biliary tract malignancies seen in patients without PD. On analysis, there was no statistically significant association found between biliary tract malignancies and PD. Sub-analysis was done after adding the 42 patients with ampullary adenomas in the cases. There was again no difference noted between the cases and the controls. Conclusions - There is no definite association between pancreas divisum and causation of biliary malignancies.

Original languageEnglish (US)
Pages (from-to)24-26+28-30+34
JournalPractical Gastroenterology
Issue number12
StatePublished - Dec 1 2007

ASJC Scopus subject areas

  • Gastroenterology

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    Fatima, H., Malcolm, M., Sherman, S., Fogel, E. L., Mchenry, L., Watkins, J. L., Howard, T. J., Ruffolo, T. A., Nugent, C. E., Hassan, A. A. A., & Lehman, G. A. (2007). Pancreas divisum: A retrospective review to evaluate the risk of biliary tract neoplasms. Practical Gastroenterology, 31(12), 24-26+28-30+34.