Pancreas divisum: A study of the cadaveric donor pancreas for islet isolation

Objectives: Pancreas divisum, the most frequent congenital variant of pancreatic ductal configuration, might impair intraductal delivery of enzyme for islet isolation. We investigated the frequency of pancreas divisum and its effect on the digestion process in islet isolation. Methods: Two catheters were placed into the main duct in opposite directions following dissection of the duct in the mid-body of cadaveric donor pancreata. When the majority of outflow was observed through the Santorini orifice by injecting solution through the catheter toward head, a diagnosis of pancreas divisum was made. Results: Twenty-eight cases of a total of 127 pancreata evaluated were described as having pancreas divisum. There were no significant differences in donor demographics, donor instability, pancreas weight, or undigested tissue weight between donors with and without pancreas divisum. In the 28 cases of pancreas divisum, there was moreover no observable difference in the quality of distention between the ventral and dorsal pancreas. Islet yield after digestion was comparable between cases with and without pancreas divisum. Conclusion: We found that Santorini's duct was the major drainage route of the pancreas in 22% of individuals. Pancreas divisum did not have a negative impact on the digestion process and outcome of islet isolation.