Pancreatographic investigation of pancreatic duct system and pancreaticobiliary malformation

Kamisawa, Terumi; Okamoto, Akira

doi:10.1111/j.1469-7580.2007.00843.x

Cited by 11 publications

(12 citation statements)

References 23 publications

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“…The three subtypes of pancreas divisum were identified in the present MRCP study, which is similar to the findings of Adibelli et al 7 and Kamisawa and Okamoto. 21 In the present cadaveric study, ansa pancreatica (type V) was observed in one cadaveric specimen, but not radiologically. It was reported radiologically in the MRCP (1.2%) by Adibelli et al 7 Hayashi et al 22 found that it has a significant association with recurrent acute pancreatitis.…”

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confidence: 61%

Anatomical Patterns of the Pancreatic Ductal System – A Cadaveric and Magnetic Resonance Cholangiopancreatography Study

et al. 2019

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Introduction Morphological variants of the pancreatobiliary system can predispose to chronic pancreatitis. The goal of the present study is to assess the prevalence of pancreatic duct patterns in the Indian population, both by cadaveric dissection and by magnetic resonance cholangiopancreatography (MRCP). Materials and Methods A total of 15 adult pancreas specimens of unknown age and gender, and 5 fetal pancreas specimens of different gestational ages with the intact second part of duodenum, were dissected by the piecemeal method. For clinical relevance, MRCP images of 103 clinically-diagnosed chronic pancreatitis patients irrespective of their etiology were obtained retrospectively from the existing database and studied. The anatomical patterns were classified as five different types based on the course of the main pancreatic duct and the accessory pancreatic duct and their openings into the duodenal wall, including variants like pancreas divisum and ansa pancreatica. Results In the cadaveric study, the main pancreatic duct was single with a straight course in 46.67% of the adult specimens, and in the MRCP study, the main pancreatic duct showed a descending course in 77.66% of the cases. The most common pattern was type III in both the cadaveric (80%) and radiological (55.33%) studies, and the accessory duct was absent on the MRCP in all type-III cases, while it ended blindly in the cadaveric specimens. Ansa pancreatica (type V) was observed in 1 adult specimen (6.7%), but not in the radiological study. Pancreas divisum (type IV) was observed in the 8 cases (7.76%) cases in the radiological study. Conclusion Knowledge of the anatomical variants of the pancreatic ductal system may be helpful for the radiologists during diagnostic and therapeutic interventional procedures.

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confidence: 61%

Anatomical Patterns of the Pancreatic Ductal System – A Cadaveric and Magnetic Resonance Cholangiopancreatography Study

et al. 2019

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“…The development of the human pancreas embryology is complex, resulting in many different congenital pancreaticobiliary variations [ 1 , 3 ]. The human pancreas develops from the ventral and dorsal pancreatic buds whose fusion causes the anastomosis of the pancreatic ducts at the 6th to 7th embryological week [ 1 , 8 , 9 , 15 , 16 ]. The ventral pancreatic duct and the distal part of the dorsal pancreatic duct are anastomosed and form the MPD of Wirsung, while the proximal part of the dorsal pancreatic duct becomes the APD of Santorini [ 1 , 9 , 15 ].The major pancreatic duct opens into the ampulla of Vater, and the minor pancreatic duct opens into the minor papilla [ 1 , 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…In many of the articles that we found in the literature, the authors did not use this kind of classification; instead, they used the term “normal pancreatic duct” to describe a pancreas that could be classified as type 1, 2, or 3. Therefore, we could not separate the patients between these three groups, and we presented them as a unique type of normal pancreatic duct anatomy ( Tables 2 and 3 , [ 3 - 5 , 7 , 9 - 14 ]). In addition, some authors used a different type of pancreatic duct classification (e.g., Bang et al (2006) [ 7 ]; Bulow et al (2014) [ 5 ]), and the correspondence was made according to the descriptions they used for the type of pancreatic duct they studied.…”

Section: Discussionmentioning

confidence: 99%

“…A total of 8,260 patients were analyzed in our study, of which 94.3% of cases displayed normal anatomy (types 1 - 3), 4.5% displayed pancreas divisum, and 1.2% were reported with rare anomalies. The studies that were considered eligible in our review consisted of five retrospective studies, four prospective studies, and one multicenter retrospective study ( Table 1 , [ 3 - 5 , 7 , 9 - 14 ]).…”

Section: Literature Retrievedmentioning

confidence: 99%

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The Main Anatomical Variations of the Pancreatic Duct System: Review of the Literature and Its Importance in Surgical Practice

et al. 2018

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Anatomical variations or anomalies of the pancreatic ducts are important in the planning and performance of endoscopic retrograde cholangiopancreatography (ERCP) and surgical procedures of the pancreas. Normal pancreatic duct anatomy occurs in approximately 94.3% of cases, and multiple variations have been described for the remaining 5.7%. The purpose of this study was to review the literature on the pancreatic duct anatomy and to underline its importance in daily invasive endoscopic and surgical practice. Two main databases were searched for suitable articles published from 2000 to 2017, and results concerning more than 8,200 patients were included in the review. The most common anatomical variation was that of pancreas divisum, which appeared in approximately 4.5% of cases.

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“…We have prospectively studied the anatomy of the pancreatic duct system using endoscopic retrograde pancreatography [6,7,8,9]. To achieve optimal visualization, several pancreatograms of the head of the pancreas were taken with the patient in the prone or slightly oblique position.…”

Section: Methodsmentioning

confidence: 99%

A New Embryological Theory of the Pancreatic Duct System

Kamisawa¹,

Takuma²,

Egawa³

et al. 2010

Dig Surg

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Background/Aims: To clarify the anatomy of the pancreatic duct system and to investigate its embryology. Methods: We reviewed pancreatograms of 256 patients with a normal pancreatic head and 36 cases of complete pancreas divisum. Results: Accessory pancreatograms were divided into two patterns. The long-type accessory pancreatic duct (APD) forms a straight line and joins the main pancreatic duct (MPD) at the neck portion of the pancreas. The short-type APD joins the MPD near its first inferior branch. The short-type APD is 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 short- and long-type APD. The first long inferior branch from the long-type APD passes through the MPD near the origin of the inferior branch from the MPD. Immunohistochemically, in the short-type APD, the MPD between the junction of the short-type APD and the neck portion originated from the ventral pancreas. Conclusion: The long-type APD represents a continuation of the main duct of the dorsal pancreatic bud. The short-type APD is very likely formed by the proximal main duct of the dorsal pancreatic bud and its long inferior branch, with the main duct of the dorsal pancreatic bud at the point of connection with the main duct of the ventral pancreatic bud being obliterated and replaced by this additional communication.

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Pancreatographic investigation of pancreatic duct system and pancreaticobiliary malformation

Cited by 11 publications

References 23 publications

Anatomical Patterns of the Pancreatic Ductal System – A Cadaveric and Magnetic Resonance Cholangiopancreatography Study

Anatomical Patterns of the Pancreatic Ductal System – A Cadaveric and Magnetic Resonance Cholangiopancreatography Study

The Main Anatomical Variations of the Pancreatic Duct System: Review of the Literature and Its Importance in Surgical Practice

A New Embryological Theory of the Pancreatic Duct System

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