Fusion and duplication variants of pancreatic duct system
The aim of this study was to assess the incidence of fusion and duplication variants of the pancreatic duct system and their clinical significance. A total of 650 endoscopic retrograde cholangiopancreatography were reviewed; 485 cases with satisfactory imaging of the pancreatic ducts were included in the study. Anatomic variants were observed in 48 patients (9.9%), fusion variants were 54.1% of the cases (22 pancreas divisum and 4 functional divisum), and duplication variants were 45.8% (13 bifurcations of the main pancreatic duct, 4 loop, 2N-shape, 3 ring). Clinical indications to endoscopic cholangiopancreatography were idiopathic acute pancreatitis (33.3%), suspected chronic pancreatitis (18.7%), unexplained abdominal pain (14.5%), suspected pancreatic mass (10.4%), chronic hyperamylasemia (6.2%), and acute biliary pancreatitis (16.6%). Except for acute biliary pancreatitis (significantly more frequent in duplication variants), no statistical difference was observed between the groups with anatomical variants concerning clinical features.
Key WordsPancreatic ducts anatomical variants pancreas divisum idiopathic acute pancreatitis biliary acute pancreatitis endoscopic cholangiopancreatography
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- 1.Siegel JH, ed. Radiologic interpretation: normal biliary system and variations; normal pancreatic duct and variations,in Endoscopic Retrograde Cholangio Pancreatography— Technique, Diagnosis and Therapy. Raven, New York, 1992, pp. 25–59.Google Scholar
- 2.Cotton PB, Williams CB, eds.Practical Gastrointestinal Endoscopy, 3rd ed. Blackwell, Oxford, 1990.Google Scholar
- 20.Pott G, Schrameyer B, eds.ERCP Atlas. Schattauer, Stuttgart, 1989, p. 32.Google Scholar
- 21.Gulliver DJ, Cotton PB, Baillie J. Anatomic variants and artifacts in ERCP interpretation.Am J Radiol 1991; 156: 975–980.Google Scholar