Minor papillotomy—a procedure that widens the minor pancreatic duct opening—demonstrated a 65% reduction in recurrent pancreatitis episodes among patients with pancreas divisum, a congenital anatomical variant affecting 5-10% of the population. The randomized trial followed 177 adults with unexplained recurrent acute pancreatitis, comparing the endoscopic intervention to conservative management over a median 57-month follow-up period. This finding challenges decades of debate within gastroenterology about whether anatomical pancreatic variants require surgical intervention. Pancreas divisum occurs when embryonic pancreatic ducts fail to fuse properly, potentially creating drainage bottlenecks that trigger inflammatory episodes. While the condition is relatively common, most carriers remain asymptomatic throughout life. The study's significance lies in providing the first randomized evidence for intervention in symptomatic cases, where patients often endure repeated hospitalizations and progressive pancreatic damage. However, the procedure requires specialized expertise available primarily at tertiary centers, and patient selection remains crucial since not all pancreas divisum cases benefit from intervention. The research offers a targeted therapeutic pathway for a subset of patients with otherwise intractable recurrent pancreatitis.