Exploring the clinical characteristics and prevalence of the annular pancreas: a meta-analysis

• Published in: HPB (Oxford, England) Vol. 26; no. 4; pp. 486 - 502
• Main Authors: Plutecki, Dawid, Ostrowski, Patryk, Bonczar, Michał, Michalik, Weronika, Konarska-Włosińska, Monika, Goncerz, Grzegorz, Juszczak, Aleksiej, Ghosh, Sanjib K., Balawender, Krzysztof, Walocha, Jerzy, Koziej, Mateusz
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-04-2024
• Subjects: Adult; Child; Digestive System Abnormalities - epidemiology; Digestive System Abnormalities - surgery; Duodenal Obstruction - complications; Duodenal Obstruction - diagnosis; Duodenal Obstruction - surgery; Humans; Pancreas - abnormalities; Pancreas - surgery; Pancreatic Diseases - complications; Pancreatic Diseases - epidemiology; Pancreatic Diseases - surgery; Prevalence
• ISSN: 1365-182X; 1477-2574; 1477-2574
• DOI: 10.1016/j.hpb.2024.01.006

The annular pancreas (AP) is a rare gastrointestinal congenital malformation, in which malrotation of the pancreatic ventral bud in the seventh week of embryonic development manifests in a partial or complete ring of tissue around the second part of the duodenum.
The main online medical databases such as PubMed, ScienceDirect, Wiley online library, Web of Science, and EBSCO discovery service were used to gather all relevant studies on the AP.
A total of 12,729,118 patients were analyzed in relation to the prevalence of AP. The pooled prevalence of AP was 0.0045% (95% CI: 0.0021%–0.0077%). The most frequent comorbidity in adults and children was duodenal obstruction, with a pooled prevalence of 24.04% and 52.58%, respectively (95% CI: 6.86%–46.48% and 35.56%–69.31%, respectively). The most frequent operation in adult patients with AP was duodenojejunostomy, with pooled prevalence established at 3.62% (95% CI: 0.00%–10.74%).
The diagnostic complexity of AP is accentuated by its nonspecific clinical symptoms, making accurate identification reliant on imaging studies. Therefore, having a thorough knowledge of the clinical characteristics of the AP and its associated anomalies becomes paramount when faced with this rare congenital condition.