Incomplete Pancreas Divisum With Anomalous Choledochopancreatic Duct Junction With Choledochal Cyst

Dalvi, Abhay; Pramesh, C S; Prasanna, G. S.; Rege, Sameer; Khare, Ritu; Ravikiran, C. S.

doi:10.1001/archsurg.134.10.1150

Cited by 18 publications

(10 citation statements)

References 4 publications

(3 reference statements)

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“…Branch fusion is reported to be sometimes accompanied by congenital choledochal cyst [17, 18], and we believe that concomitant branch fusion was also present in the 2 cases of congenital choledochal cyst in the present series. As in cases of branch fusion, embryonic-type pancreatic ducts (main drainage duct of the ventral and dorsal buds) are communicated by the branches, many of them showed Santorini’s duct dominance.…”

Section: Discussionsupporting

confidence: 67%

Clinical and Radiological Findings in Dominance of Santorini’s Duct

Kamisawa

Egawa²,

Nakajima³

et al. 2004

Digestion

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Background/Aims: Few studies on Santorini’s duct dominance, in which the ventral pancreatic duct is narrower than and anastomoses with Santorini’s duct have been performed. We examined clinical and radiological findings in cases characterized by dominance of Santorini’s duct. Methods: We reviewed 3,800 cases of endoscopic retrograde cholangiopancreatography. Clinical and pancreatographic findings including caliber, course, terminal shape, and patency of Santorini’s duct were examined in cases of Santorini’s duct dominance. Results: Twenty-nine cases were diagnosed as Santorini’s duct dominant. Chronic pancreatitis, acute relapsing pancreatitis, pancreatic-type pain, and hyperamylasemia not associated with obvious pancreatitis were observed in 3, 1, 5, and 6 cases, respectively. Cholangiopancreatographic findings indicated congenital choledochal cyst (n = 2), branch fusion between the ventral and dorsal pancreatic ducts (n = 23), and normal pancreatic duct system characterized by a straight course through the body and tail to join the ventral pancreatic duct in the neck portion of the pancreas (n = 4). Regarding terminal shapes of Santorini’s duct, cudgel type (n = 9) and spindle type (n = 8), which showed frequent patency, were observed significantly more frequently than in controls. Patency of Santorini’s duct was observed in 90% (17/19). Conclusions: Many Santorini’s duct-dominant cases exhibited branch fusion between the ventral and dorsal pancreatic ducts. Although Santorini’s duct functions well in most cases in which it is dominant, pancreatitis or pancreatic-type pain occurs in half of such cases due to relative impairment of function of the minor duodenal papilla.

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Section: Discussionsupporting

confidence: 67%

Clinical and Radiological Findings in Dominance of Santorini’s Duct

Kamisawa

Egawa²,

Nakajima³

et al. 2004

Digestion

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“…Using imaging, one can visualize the changes of the pancreas parenchyma, the dilatation of the pancreatic duct, and the presence of a protein plug. This may be accompanied by pancreas divisum or an annular pancreas [16][17][18]. 3.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic impact of computed tomography cholangiography and magnetic resonance cholangiopancreatography on pancreaticobiliary maljunction

Fumino

Ono

Kimura

et al. 2011

Journal of Pediatric Surgery

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“…No hereditary pattern or genetic predisposition has been established so far, although the occurrence of bile duct cysts in members of the same family has been reported 38,39 . The presence of different Todani types within the same family 38,39 , as well as anecdotal reports of associated cystic variations in the hepaticobiliary-pancreatic tract 40,41 , may reflect the concept that bile duct cysts represent an extreme of a global field defect in the affected hepatobiliary tree. Sex hormones or congenital intrauterine disturbances and endocrine function have not been implicated in any current hypothesis, despite the higher incidence in females and in infancy.…”

Section: Aetiologymentioning

confidence: 99%

Bile duct cysts in adults

Søreide

Kørner

Havnen

et al. 2004

British Journal of Surgery

179

191

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An increasing rate of occurrence of bile duct cyst is reported in adults. Type IV cysts are more frequent in adults than children. Presentation tends to be non-specific abdominal discomfort. Related hepatobiliary or pancreatic disease frequently precedes recognition, and may complicate the postoperative course. Surgical treatment aims to relieve complications deriving from the cysts and to reduce the significant risk of malignant change within the biliary tree. Complete cyst resection, cholecystectomy and Roux-en-Y hepaticojejunostomy reconstruction is standard. Controversy exists about the role of hepatic resection in type IV and V cysts, and the role of minimally invasive and laparoscopic treatment. In general, the outcome is good and a near-zero mortality rate has been reported in institutional series over the past decade.

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Incomplete Pancreas Divisum With Anomalous Choledochopancreatic Duct Junction With Choledochal Cyst

Cited by 18 publications

References 4 publications

Clinical and Radiological Findings in Dominance of Santorini’s Duct

Clinical and Radiological Findings in Dominance of Santorini’s Duct

Diagnostic impact of computed tomography cholangiography and magnetic resonance cholangiopancreatography on pancreaticobiliary maljunction

Bile duct cysts in adults

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