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Endoscopic retrograde pancreatography

Analysis of the normal pancreatogram

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Abstract

Thirty-five pancreatograms were selected from 62 which were obtained during endoscopic cannulation of the papilla of Vater with retrograde injection of radiopaque medium. Pancreatograms were selected on the basis of the quality of the study and on the absence of any clinically demonstrable pancreatic disease. Measurements were made of the main pancreatic duct (MPD) in the head, body, and tail, as well as the length of the duct. Althought there is a wide range of normal, practical reference figures for the diameters of the main duct in the head, body, and tail are 3, 2, and 1 mm, respectively. The length averages 15.4 cm. No correlation was found between the measurements and the body surface area, age, or sex of the patient. Comparisons are made with other autopsy and endoscopic studies, and attention is focused on the salient anatomic features, including normal points of narrowing of the duct, the accessory pancreatic duct (APD), and the main pancreatic duct branches (MPDB).

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References

  1. McCune WS, Shorb PE, Moscovitz H:Endoscopic cannulation of the ampulla of Vater. Ann Surg 167:752–756, 1968

    PubMed  Google Scholar 

  2. Oi I, Kobayashi S, Kondo T: Endoscopic pancreatocholangiography. Endoscopy 2:103–106, 1970

    Google Scholar 

  3. Oi I: Fiberduodenscopy and endoscopic pancreaticocholangiography. Gastrointest Endosc 17:59–62, 1970

    PubMed  Google Scholar 

  4. Kasugai T, Kuno N, Aoki I, et al.: Fiberduodenoscopy; analysis of 353 examinations. Gastroitest Endosc 18:9–16, 1971

    Google Scholar 

  5. Ogoshi K, Niwa M, Hara Y, et al: Endoscopic pancreatocholangiography in the evaluation of pancreatic and biliary disease. Gastroenterology 64:210–216, 1973

    PubMed  Google Scholar 

  6. Takagi K, Ikeda S, Nakagawa Y, et al: Retrograde pancreatography and cholangiography by fiberduodenoscope. Gastroenterology 59:445–452, 1970

    PubMed  Google Scholar 

  7. Cotton PB, Blumgart LH, Davies GT, et al: Cannulation of papilla of Vater via fiber-duodenoscope: Assessment of retrograde cholangiopancreatography in 60 patients. Lancet 1:53–58, 1972

    PubMed  Google Scholar 

  8. Christen TP, Pruszynski B: Retrograde pancreatocholangiography. The radiologic picture of the pancreatic duct in carcinoma of the pancreas. Pol Rev Nad Nucl Med 36:548–556, 1972

    Google Scholar 

  9. Liquory CL, Goerou H, Monnier JP, et al: Endoscopic catheterisation of the pancreatic ducts. Sem Hop (Paris) 49:529–535, 1973

    Google Scholar 

  10. Deyhle P, Fumagalli J, Paez C, et al: Klinischer wert der endoskopischen retrograden pankreato-cholangiographie. Dtsch Med Wochenschr 97:1139–1141, 1972

    PubMed  Google Scholar 

  11. Nagy GS: Endoscopic pancreatocholangiography. Med J Aust 2:725–729, 1973

    PubMed  Google Scholar 

  12. Safrany L, Tari J, Barna L, et al: Endoscopic retrograde cholangiography. Experience of 168 examinations. Gastrointest Endosc 19:163–168, 1973

    PubMed  Google Scholar 

  13. Vennes JA, Silvis SE: Endoscopic visualization of bile and pancreatic ducts. Gastrointest Endosc 18:149–152, 1972

    PubMed  Google Scholar 

  14. Eaton SB, Flischli DJ, Pollard JJ, et al: Comparison of current radiologic approaches to the diagnosis of pancreatic disease. N Engl J Med 279:389–396, 1968

    PubMed  Google Scholar 

  15. Bachrach WH, Birsner JW, Izenstark JL, et al: Pancreatic scanning: A review. Gastroenterology 63:890–910, 1972

    PubMed  Google Scholar 

  16. Braasch JW, Gregg JA: Surgical uses of peroral retrograde pancreatography and cholangiography. Am J Surg 125:432–436, 1973

    PubMed  Google Scholar 

  17. Dickinson PB, Belsito AA, Cramer GG: Diagnostic value of endoscopic cholangiopancreatography. JAMA 225:944–948, 1973

    PubMed  Google Scholar 

  18. Kasugai T, Kuno N, Kizu M, et al: Endoscopic pancreatocholangiography. II. The pathological endoscopic pancreatocholangiogram. Gastroenterology 63:227–234, 1972

    PubMed  Google Scholar 

  19. Nebel OT, Farnes MF: Endoscopic pancreatocholangiography. Am J Dig Dis 18:1042–1050, 1973

    PubMed  Google Scholar 

  20. Norton RA, Ogoshi K, Hara Y, et al: Pancreatographic abnormalities due to pancreatic cancer. Gastrointest Endosc 20:13–14, 1973

    PubMed  Google Scholar 

  21. Silvis SE, Rohrmann CA, Vennes JA: Diagnostic criteria for the evaluation of the endoscopic pancreatogram. Gastrointest Endosc 20:51–55, 1973

    PubMed  Google Scholar 

  22. Classen M, Hellwig H, Rösch W: Anatomy of the pancreatic duct. A duodenoscopic-radiological study. Endoscopy 5:14–17, 1973

    Google Scholar 

  23. Kasugai T, Kuno N, Kobayashi S, et al: Endoscopic pancreatocholangiography. I. The normal endoscopic pancreatocholangiogram. Gastroenterology 63:217–226, 1972

    PubMed  Google Scholar 

  24. Cotton PB: The normal endoscopic pancreatogram. Endoscopy 6:65–70, 1974

    Google Scholar 

  25. Sivak MV, Jr, Sullivan BH, Jr: Endoscopic retrograde cholangiopancreatography (ERCP). Cleveland Clin Q 41:93–101, 1974

    Google Scholar 

  26. DuBois EF: Basal Metabolism in Health and Disease, 3rd ed. Philadelphia, Lea and Febiger, 1936, p 131

    Google Scholar 

  27. Berman LG, Prior JT, Abramow SM: A study of the pancreatic duct system in man by the use of vinyl acetate casts of postmortem preparations. Surg Gynecol Obstet 110:391–403, 1960

    PubMed  Google Scholar 

  28. Hand BH: An anatomical study of the choledochoduodenal area. Br J Surg 50:486–494, 1962

    Google Scholar 

  29. Howard JM, Short WF: An evaluation of pancreatography in suspected pancreatic disease. Surg Gynecol Obstet 129:319–324, 1969

    PubMed  Google Scholar 

  30. Newman HF, Weinburg SB, Newman EB, et al: The papilla of Vater and distal portions of the common bile duct and duct of Wirsung. Surg Gynecol Obstet 106:687–694, 1958

    PubMed  Google Scholar 

  31. Cotton PB: Progress report. Cannulation of the papilla of Vater by endoscopy and retrograde cholangiopancreatography (ERCP). Gut 13:1014–1025, 1972

    PubMed  Google Scholar 

  32. Birnsting M: A study of pancreatography. Br J Surg 47:128–139, 1959

    PubMed  Google Scholar 

  33. Trapnell JE, Howard JM: Transduodenal pancreatography; an improved technique. Surgery 60:1112–1119, 1966

    PubMed  Google Scholar 

  34. Okuda K, Someya N, Goto A, et al: Endoscopic pancreatocholangiography; a preliminary report on technique and diagnostic significance. Am J Roentgenol Radium Ther Nucl Med 117:437–445, 1973

    PubMed  Google Scholar 

  35. Millbourn E: Calibre and appearance of the pancreatic ducts and relevant clinical problems. A roentgenographic and anatomical study. Acta Chir Scand 118:286–303, 1960

    PubMed  Google Scholar 

  36. Rienhoff WF, Pickrell KL: Pancreatitis; an anatomic study of the pancreatic and extrahepatic biliary systems. Arch Surg 51:205–219, 1945

    Google Scholar 

  37. Doubilet H, Poppel MH, Mulholland JH: Pancreatography. Technics, principles and observations.Radiology 64:325–339, 1955

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Section of Gastrointestinal Endoscopy, Department of Gastroenterology, The Cleveland Clinic Foundation, 9500 Euclid Avenue, 44106, Cleveland, Ohio

    Michael V. Sivak Jr. MD & B. H. Sullivan Jr. MD

  2. The Cleveland Clinic Educational Foundation, Cleveland, Ohio

    Michael V. Sivak Jr. MD & B. H. Sullivan Jr. MD

Authors
  1. Michael V. Sivak Jr. MD
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  2. B. H. Sullivan Jr. MD
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Sivak, M.V., Sullivan, B.H. Endoscopic retrograde pancreatography. Digest Dis Sci 21, 263–269 (1976). https://doi.org/10.1007/BF01095900

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