Branch Fusion Between the Ventral and Dorsal Pancreatic Duct

Abstract

: Fusion of the dorsal and ventral pancreatic ducts exhibits various forms and one of them is branching fusion. Branch fusion was divided into 3 types according to ERP findings. Fusion of the upper branches of the ventral pancreatic duct with the dorsal pancreatic ducts was designated as being type 1. Fusion of the lower branch of the dorsal pancreatic duct with the ventral pancreatic duct in roundabout way was designated as being type 2. Fusion of the lower branch of the dorsal pancreatic duct with the ventral pancreatic duct in short way was designated as being type 3. We demonstrated the presence of branch fusion involving the branch of the dorsal pancreatic duct by histopathological examination and immunohistochemical examination using pancreatic polypeptide cells as an indicator in one patient with type 1 branch fusion and one with type 3 branch fusion who underwent a pancreatoduodenectomy. ERP showed chronic pancreatitis in 3 of 4 patients with type 1, 3 of 8 patients with type 2, and 7 of 18 patients with type 3 branch fusion, of whom 1, 2, and 4, respectively had non‐alcoholic pancreatitis. The high incidence of pancreatitis suggested that branch fusion is the cause of pancreatitis. In addition, evaluation of ERP images revealed Santorini's duct originating from the ventral pancreatic duct in 5 patients with type 1 branch fusion, suggesting the presence of the ansa pancreatica proposed by Dawson. This finding may also be closely associated with the development of pancreatitis. (Dig Endosc 1994; 6 : 87–93)

Pancreatographic investigation of pancreatic duct system and pancreaticobiliary malformation

“…1987). Based on the embryology and radiological findings, Hirooka et al. (1994) proposed the concept of branch fusion between the ventral and dorsal pancreatic ducts; this concept had previously been confirmed pathologically (Suda et al.…”

Pancreatic Duct System With 2 Points of Embryological Fusion Between the Ventral and Dorsal Pancreatic Ducts

“…1Y3 On the other hand, intraductal papillary mucinous neoplasm (IPMN) is a risk factor for pancreatic cancer. 4 To our knowledge, IPMN associated with AIP has not been reported previously. Here, we report the first case of IPMN associated with AIP.…”

“…1Y3 In cases of incomplete pancreas divisum, 3 patterns of branch fusion have been suspected, namely, the extreme end of a superior branch of the VPD fuses with the DPD, an inferior branch of the VPD fuses with an inferior branch of the DPD, or an inferior branch of the DPD fuses with the VPD. 4,5 Even in these anomalous cases, there is only one connecting point between the VPD and DPD. In consideration of the concept of branch fusion, in the current case, an inferior branch from the DPD may have fused with the VPD, and the extreme end of a superior branch of the VPD may have fused with the DPD or its superior branch.…”

“…1Y3 In cases of incomplete pancreas divisum, branch fusion between the ventral pancreatic duct (VPD) and dorsal pancreatic duct (DPD) occurs. 4,5 However, even in the anomalous cases, there is only one connecting point between the VPD and DPD.…”

Clinical significance of the minor duodenal papilla and accessory pancreatic duct

“…Recently, however, the term has been widely used to describe two ductal systems that do not unite or communicate. 57 In the broad sense, the term "pancreas divisum" includes incomplete pancreas divisum 58,59 (partial pancreas divisum, 60 branch fusion between the ventral and dorsal pancreatic duct 61,62 ), in which a communication between the ventral and dorsal pancreatic duct exists as a small-caliber channel, with drainage predominantly through the MIP.…”