Indications and Contraindications

Indications ■ Strong: recurrent episodes of documented acute pancreatitis (typical pain, increased serum amylase) in patients with congenital pancreas divisum or other variants of a dominant dorsal duct (absent duct of Wirsung, filamentous communication to duct of Wirsung)

■ Weak: patients with pancreas divisum and episodic "obstructive pancreatic pain" (pain with characteristics and location attributable to a pancreatic origin but without objective substantiation by hyperamylasemia or pancreatic edema).

Contraindications ■ Chronic pancreatitis (fibrosis, major duct dilation, pseudocyst, segmental duct obstruction, calcification)

■ Pancreatitis from alcoholism, hypercalcemia, hyperlipidemia, gallstones, or trauma

■ Recent severe acute pancreatitis, significant residual inflammation/swelling

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