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Pancreatic ductal anatomy: more than meets the eye

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Abstract

Purpose

Anatomical variations of the pancreas are relatively frequent and often understudied. The ductal system of the pancreas has multiple variations, which are not frequently reported in the literature.

Materials and methods

The anatomy of the pancreas was studied through macroscopic anatomical dissection on 50 organ complexes (the pancreas, spleen, and duodenum) donated to the department of human anatomy, from patients, who died of causes not related to pancreatic diseases.

Results

In type I, the main pancreatic duct (Wirsung’s duct, MPD) and the accessory pancreatic duct (Santorini’s duct, APD) were merged but most of the head was drained by the MPD (10% of cases). In type II, the MPD and APD were merged but most of the head was drained by the APD (4% of cases). In type III, the APD was absent and the head was drained by the MPD (14% of cases). In type IV, there was an inverted pancreas divisum where the ducts did not merge but each drained a part of the head (6% of cases). Classical pancreas divisum where the ducts did not merge but each drained a part of the head was considered as type V (4% of cases). In type VI, the MPD and APD merged and each drained a part of the head (48% of cases). In type VII, the MPD and APD merged but the upper part of the head was drained by the main pancreatic duct (4% of cases). In type VIII, the MPD and APD merged but the lower part of the head was drained by the main pancreatic duct (4% of cases). In the IX type, the MPD and APD merged but the head was drained by the branches of the MPD (6% of cases).

Conclusions

There are several drainage patterns of the pancreas. In some cases, one of the ducts provides more drainage of the gland than the other. This is clinically relevant since blockage of the main source of drainage leads to pancreatic juice stasis. It also explains cases when partial or total blockage of the duct results in the pancreatitis of an isolated zone.

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Acknowledgements

The authors wish to sincerely thank those who donated their bodies to science so that anatomical research could be performed. Results from such research can potentially improve patient care and increase mankind's overall knowledge. Therefore, these donors and their families deserve our highest gratitude.

Funding

Nil.

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Authors and Affiliations

  1. Clinical Research and Development Department, Botkin Hospital, Moscow, Russia

    Serghei Covantsev

  2. Nutrition and Metabolic Diseases, Saint Spiridon County Hospital, Iasi, Romania

    Cristina Chicu

  3. Department of Anatomy, State Medical and Pharmaceutical University “Nicolae Testemitanu”, Chisinau, Republic of Moldova

    Natalia Mazuruc & Olga Belic

Authors
  1. Serghei Covantsev
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  2. Cristina Chicu
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  3. Natalia Mazuruc
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  4. Olga Belic
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Contributions

Protocol/project development—SC; data collection or management—SC, NM, OB; data analysis—SC, CC, OB; manuscript writing/editing—SC, CC, NM, OB; revision of the final version—SC, CC, NM, OB.

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Correspondence to Serghei Covantsev.

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Covantsev, S., Chicu, C., Mazuruc, N. et al. Pancreatic ductal anatomy: more than meets the eye. Surg Radiol Anat 44, 1231–1238 (2022). https://doi.org/10.1007/s00276-022-03002-w

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  • DOI: https://doi.org/10.1007/s00276-022-03002-w

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