Abstract
Background
Embryologically, the pancreatic duct system develops by the fusion between the dorsal and ventral pancreatic bud ducts. It has been suggested that the proximal part of the main dorsal pancreatic duct partially regresses to form the accessory pancreatic duct (APD). Aim of this study was to clarify the anatomy of the pancreatic duct system of the head of the pancreas and investigate the embryology of the normal pancreatic duct system.
Methods
We reviewed endoscopic retrograde pancreatography of normal pancreatic heads (n = 256) and pancreas divisum (n = 36), focusing on long inferior branches arising from the APD and the main pancreatic duct (MPD). The accessory pancreatograms were divided into two patterns of course and shape, the long type (171 cases) and the short type (85 cases) according to the length of the MPD from the orifice to the junction with the APD. The long-type APD formed a straight line and joined the MPD at the neck portion of the pancreas. The short-type APD joined the MPD near its first inferior branch.
Results
The shape of the long-type APD was quite similar to that of the dorsal pancreatic duct of pancreas divisum. The short-type APD was less likely to have a long inferior branch arising from the APD. The length of the APD from the orifice to the first long inferior branch was similar in the long-type APD (19.4 ± 4.0 mm) and in the short-type APD (18.8 ± 4.2 mm). The first long inferior branch from the long-type APD passed though the MPD near the origin of the inferior branch from the MPD, whereas the short-type APD joined the MPD near its inferior branch.
Conclusions
There are two types of APD. The long-type APD was quite similar to the shape of the dorsal pancreatic duct of pancreas divisum, and seems to represent a continuation of the main duct of the dorsal pancreatic bud. The short-type APD was less likely to have a long inferior branch, and seems to be formed by the most proximal part of the main duct of the dorsal pancreatic bud and its long inferior branch.
Similar content being viewed by others
References
Adda G, Hannoun L, Loygue J (1984) Development of the human pancreas: variations and pathology. A tentative classification. Anat Clin 5:275–283
Cotton PB (1980) Congenital anomaly of pancreas divisum as cause of obstructive pain and pancreatitis. Gut 21:105–114
Dawson W, Langman J (1961) An anatomical–radiological study on the pancreatic duct pattern in man. Anat Rec 139:59–68
Kamisawa T (2004) Clinical significance of the minor duodenal papilla and accessory pancreatic duct. J Gastroenterol 39:605–615
Kamisawa T, Koike M, Okamoto A (1999) Embryology of the pancreatic duct system. Digestion 60:161–165
Kamisawa T, Tabata I, Tajima T, Tsushima K, Yoshida Y (1997) Patency of the human accessory pancreatic duct as determined by dye-injection endoscopic retrograde pancreatography. Digestion 58:78–82
Kamisawa T, Tu Y, Egawa N, Sakaki N, Ishiwata J, Okamoto A (1998) New classification for the accessory pancreatic duct by ERP. Dig Endosc 10:308–311
Kamisawa T, Tu Y, Egawa N, Ishiwata J, Okamoto A (1998) Patency of the accessory pancreatic duct in relation to its course and shape: a dye-injection endoscopic retrograde pancreatography study. Am J Gastroenterol 93:2135–2140
Kamisawa T, Tu Y, Egawa N, Ishiwata J, Okamoto A (2001) A new embryologic hypothesis of annular pancreas. Hepatogastroenterology 48:277–278
Skandalakis LJ, Gray SW, Skandalakis JE (1993) Surgical embryology and anatomy of the pancreas. Surg Clin North Am 73:661–697
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kamisawa, T., Tu, Y., Egawa, N. et al. Pancreatographic investigation of the pancreatic duct system. Surg Radiol Anat 29, 405–408 (2007). https://doi.org/10.1007/s00276-007-0220-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00276-007-0220-6