Pancreas Divisum: A Retrospective Review to Evaluate the Risk of Biliary Tract Neoplasms

INTRODUCTION Pancreas divisum is the most common congenital pancreatic anomaly; occurring in approximately 7.5% of the general population. It is recognized as a potential risk factor for recurrent acute pancreatitis, and possible chronic pancreatitis. Pancreas divisum results from the failure of fusion of the ventral and dorsal ductal system. The hypothesis of our study was that pancreas divisum predisposes to biliary tract malignancies, namely cholangiocarcinoma (CCA) and ampullary carcinoma (ACA). This hypothesis budded from the known association of biliary tract malignancies with congenital anomalies of the biliary tract as elaborated below. Cholangiocarcinoma is an uncommon cancer developing in the epithelial cells of the intrahepatic and extrahepatic bile ducts and/or periductular glands of the biliary tract. It accounts for around 3% of all gastrointestinal malignancies (1), and incidence increases with age. Greater than 95% are adenocarcinomas, and a majority A SPECIAL ARTICLE