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A study on the human pancreaticobiliary duct system and ampulla region with their clinical considerations

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Abstract

Introduction

The purpose of this study is to present the variations of the pancreatic duct system and hepatopancreatic ampulla so that an awareness of these variations may help in surgical planning and prevention of ductal injury.

Methods

Forty human pancreatic specimens were used to study the duct pattern of the pancreas and the formation and mode of termination of the pancreatic ducts. Also, the patency of the main pancreatic ducts, length of the hepatopancreatic ampulla, and length of the main pancreatic duct were measured.

Results

The main pancreatic duct was patent in 37 out of 40 specimens, 2 specimens showed the embryonic type of the duct system, and one had the duct obliterated at its duodenal end. The mode of termination of the main pancreatic and common pancreatic ducts was divided into four types. Seventy-five percent specimens belonged to type I, followed by type II in 22.5 % and type III in 2.5 % of specimens. The length of the main pancreatic duct ranged from 11 to 21.2 cm, the average being 17.3 cm, and the length of the hepatopancreatic ampulla varied from 1 to 10 mm (1 to 2 mm—5 %, 3 to 8 mm—55 %, and more than 8 mm in 15 % of specimens), and it was absent in 25 %.

Conclusion

Awareness of these anomalies may help in surgical planning and prevention of undue ductal injury.

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References

  1. Turkvatan A, Erden A, Turkoglu MA, Yener O. Congenital variants and anomalies of the pancreas and pancreatic duct: imaging by magnetic resonance cholangiopancreaticography and multidetector computed tomography. Korean J Radiol. 2013;14:905–13.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Schulte SJ. Embryology, normal variation, and congenital anomalies of the pancreas. In: Stevenson GW, Freeny PC, Margulis AR, Burhenne HJ, eds. Margulis’ and Burhenne’s Alimentary Tract Radiology. 5th ed. St. Louis: Mosby; 1994. p. 1039–51.

  3. Kozu T, Suda K, Toki F. Pancreatic development and anatomical variation. Gastrointest Endosc Clin N Am. 1995;5:1–30.

    CAS  PubMed  Google Scholar 

  4. Yu J, Turner MA, Fulcher AS, Halvorsen RA. Congenital anomalies and normal variants of the pancreaticobiliary tract and the pancreas in adults: part 2, pancreatic duct and pancreas. AJR Am J Roentgenol. 2006;187:1544–53.

  5. Stern CD. A historical perspective on the discovery of the accessory duct of the pancreas, the ampulla of Vater and pancreas divisum. Gut. 1986;27:203–12.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Petrasek J, Hucl T, Spicak J. Pancreaticobiliary malunion and incomplete pancreas divisum: an unusual cause of common bile duct obstruction. Adv Med Sci. 2008;53:6–10.

    Article  CAS  PubMed  Google Scholar 

  7. Edge MD, Hoteit M, Ptel AP, Wang X, Baumgarten DA, Cai Q. Clinical significance of main pancreatic duct dilation on computed tomography: single and double duct dilation. World J Gastroenterol. 2007;13:1701–5.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Tank PW. Grant’s Dissector. 15th ed. Philadelphia: Wolters Kluwer; 2012. p. 113.

    Google Scholar 

  9. Howard JM, Jordan GL, Reber HA, eds. Surgical Diseases of the Pancreas. Philadelphia: Lea and Febiger; 1987. p. 8–22.

  10. Dowdy GS Jr, Waldron GW, Brown WG. Surgical anatomy of the pancreatobiliary ductal system. Observations. Arch Surg. 1962;84:229–46.

  11. Williams PL. ed. Gray’s Anatomy: The Anatomical Basis of Medicine and Surgery. 38th ed. Edinburgh: Churchill Livingstone; 1995. p. 1790–1. 1811.

  12. Gosavi VS, Gaikwad PG. The duct system of the human pancreatic gland. J Anat Soc India. 1980;29:142–6.

    Google Scholar 

  13. Klöppel G, Schlüter E. Pathology of the pancreas. In: Baert AL, Delorme G, Van HL, eds. Radiology of the Pancreas. 2nd ed. Berlin: Springer-Verlag; 1999. pp. 69–100.

  14. MacCarty RL, Stephens DH, Brown AL Jr, Carlson HC. Retrograde pancreatography in autopsy specimens. Am J Roentgenol Radium Ther Nucl Med. 1975;123:359–66

  15. Misra SP, Gulati P, Choudhary V, Anand BS. Pancreatic duct abnormalities in gall stone disease: an endoscopic retrograde cholangiopancreatographic study. Gut. 1990;31:1073–5.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  16. Kreel L, Sandin B. Changes in pancreatic morphology associated with aging. Gut. 1973;14:962–70.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  17. Kamisawa T, Koike M, Okamoto A. Embryology of the pancreatic duct system. Digestion. 1999;60:161–5.

    Article  CAS  PubMed  Google Scholar 

  18. Misra SP, Dwivedi M. Pancreaticobiliary ductal union. Gut. 1990;31:1144–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  19. Dhar P, Aslam M, Gandotra A. Study of pancreatic duct system in humans. J Anat Soc India. 1989;38:96–100.

    Google Scholar 

  20. Wilasrusmee C, Pongchairerks P. Pancreaticobiliary ductal anatomy in Thai people. J Hepatobiliary Pancreatol Surg. 1999;6:79–85.

    Article  CAS  Google Scholar 

  21. Jones BA, Salsberg BB, Bohnen JMA, Mehta MH. Common pancreaticobiliary channels and their relationship to gall stone size in gallstone pancreatitis. Ann Surg. 1987;205:123–5.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  22. DiMagno EP, Shorter RG, Taylor WF, Go VL. Relationship between pancreaticobiliary ductal anatomy and pancreatic ductal and parenchymal histology. Cancer. 1982;49:361–8.

    Article  CAS  PubMed  Google Scholar 

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Conflict of interest

LCP, ASD, KVR, and KMRB confirm that they have no conflict of interest to declare.

Ethics statement

The study was performed in a manner to confirm with the Helsinki Declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights. Also, the authors followed the policy concerning informed consent as shown on the Springer publishing group.

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Authors and Affiliations

  1. Department of Anatomy, Kasturba Medical College, Manipal, 576 104, India

    Lokadolalu Chandracharya Prasanna, Antony Sylvan D’Souza & Kumar M. R. Bhat

  2. Department of Radiodiagnosis, Kasturba Medical College, Manipal, 576 104, India

    K. V. Rajagopal

Authors
  1. Lokadolalu Chandracharya Prasanna
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  2. Antony Sylvan D’Souza
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  3. K. V. Rajagopal
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  4. Kumar M. R. Bhat
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Correspondence to Lokadolalu Chandracharya Prasanna.

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Prasanna, L.C., D’Souza, A.S., Rajagopal, K.V. et al. A study on the human pancreaticobiliary duct system and ampulla region with their clinical considerations. Indian J Gastroenterol 34, 58–62 (2015). https://doi.org/10.1007/s12664-014-0526-3

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  • DOI: https://doi.org/10.1007/s12664-014-0526-3

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