Recurrent Pancreatitis Risk in Pancreas Divisum Not Reduced by Minor Papillotomy

Objective: To examine whether papillotomy of the minor papilla reduces the incidence of acute pancreatitis in patients with idiopathic pancreatitis and pancreas divisum. Design: Multicenter, double-blind, randomized, sham-controlled clinical trial. Participants: 148 patients (mean age, 54 years) with ≥2 episodes of pancreatitis and pancreas divisum from 21 centers in the United States and Canada, enrolled between September 2018 and August 2024. Patients with other causes of acute pancreatitis and chronic calcific pancreatitis were not included. Methods: Endoscopic ultrasound was performed in all patients before randomization. Patients were then randomized to receive either endoscopic retrograde cholangiopancreatography (ERCP) with minor papillotomy or sham ERCP without papillotomy. Primary outcome of the study was the development of an episode of acute pancreatitis >30 days after the procedure. Secondary outcomes included the number of acute pancreatitis episodes and development o more...