Ansa Pancreatica: Clinical Significance in Recurrent Acute Pancreatitis

Abstract

Objective. This study aimed to conduct a thorough literature review regarding the ansa pancreatica as a potential risk factor for recurrent acute pancreatitis, exploring its pathophysiological mechanisms and possible complications during the surgical management of pancreatic conditions.

Methods. A comprehensive search was performed in the PubMed and Scopus databases using the keyword 'Ansa Pancreatica', yielding a total of 80 articles (PubMed: 34, Scopus: 46, with 52 unique articles). After applying strict inclusion and exclusion criteria, unrelated and duplicate articles were removed, resulting in the selection of 38 relevant studies. 

Results. Ansa pancreatica was found to be a statistically significant independent risk factor for recurrent acute pancreatitis in the majority of the literature reviewed. The suggested pathophysiological mechanism involves anatomical obstruction and subsequent pre-activation of the pancreatic enzymes, causing an inflammatory cascade. Diagnosis can be established using Endoscopic Retrograde Cholangiopancreatography, Magnetic Resonance Cholangiopancreatography, or Endoscopic Ultrasonography, while treatment options are either conservative or surgical, with the invasive procedures being associated with a significant risk of complications. Furthermore, some studies have indicated a correlation between ansa pancreatica and intraductal mucinous neoplasms.

Conclusion. The findings clearly show that Ansa Pancreatica is a rare anatomical variant with significant clinical and surgical implications, underscoring the necessity for clinicians to be aware of it to mitigate complications and effectively manage pancreatic diseases.