Publication:

Annular pancreas and current approaches to surgical management

Annular pancreas is an uncommon but well documented anatomical variant. Annular pancreas has a strong embryological basis, likely resulting from errors in rotation of the ventral duct of the embryological pancreas. Despite a low prevalence, annular pancreas is associated with surgical pathology that requires urgent intervention. In neonates and adults, duodenal obstruction can pose a life-threatening risk, and prolonged inflammation of related structures in adults can result in pancreatitis, cholangitis, and ultimately pancreaticobiliary malignancy. Currently, in cases of duodenal obstruction, bypass surgery has garnered favour over resection, whereas in cases of recurrent pancreatitis and cholangitis, endoscopic retrograde cholangiopancreatography (ERCP) is preferred. Further longitudinal investigation of the risk of developing foregut malignancy with bypass as opposed to resection would be beneficial in informing guidelines for surgical management.