¿Tiene el páncreas divisum un rol determinante en la pancreatitis aguda?

Incidence and Clinical Implications of Anatomical Variations in the Pancreas and Its Ductal System: A Systematic Review and Meta-Analysis

“…Acute pancreatitis is an intracellular calcium disorder in pancreatic cells, which can trigger necro-inflammatory changes and local and systemic complications [67]. Within our study, we found different anatomical variations that could produce pancreatitis; PD was one of them, which was reported by eight articles [16,28,31,32,34,35,37,53]. These studies have as a common denominator where the presence of PD could be a predisposing factor for pancreatitis, but none of them reported that this relationship is absolute.…”

“…PD is one of the most common pancreatic variations, which is produced by an embryological failure in the fusion and rotation of the ventral and dorsal pancreatic buds, which occurs between the sixth and seventh weeks of gestation, causing variations in the pancreas’s ductal system. It can be found in a complete (classical) form, in which the pancreatic secretion is drained through the accessory pancreatic duct, or an incomplete (partial) form, in which there is communication between the ducts (ventral and dorsal) [ 12 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ] ( Figure 4 ). In pancreaticobiliary union, the main pancreatic duct joins together with the common bile duct, and they drain into the second portion of the duodenum, but variations can occur, which can be classified into three categories: V type, where the pancreatic duct and common bile duct enter the duodenal wall without a common duct; B–P type, where the common bile duct drains into the pancreatic duct main, forming a common duct; and P–B type, where the main pancreatic duct drains into the bile duct, forming a common duct [ 11 , 13 , 34 , 37 ].…”

“…Tree forest plots were carried out to see the prevalence of the variants of the ductal system of the pancreas, and a forest plot was also carried out to see the clinical correlation with PD. For the PD variant, 22 studies [ 7 , 12 , 14 , 16 , 29 , 34 , 36 , 40 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 57 , 61 , 64 , 65 ] presented a prevalence of 0.18 (0.15–0.21) and a heterogeneity of 99.52%. For the annular pancreas prevalence forest plot, 4 studies [ 11 , 15 , 24 , 66 ] were included, presenting a prevalence of 0.27 (0.01–0.5) and 97.18% heterogeneity.…”

“… Forest plot of prevalence of PD [ 7 , 12 , 14 , 16 , 29 , 34 , 36 , 40 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 57 , 61 , 64 , 65 ]. …”

“…It can be found in a complete (classical) form, in which the pancreatic secretion is drained through the accessory pancreatic duct, or an incomplete (partial) form, in which there is communication between the ducts (ventral and dorsal) [12,[27][28][29][30][31][32][33][34][35][36][37] (Figure 4). In pancreaticobiliary union, the main pancreatic duct joins together with the common bile duct, and they drain into the second portion of the duodenum, but variations can occur, which can be classified into three categories: V type, where the pancreatic duct and common bile duct enter the duodenal wall without a common duct; B-P type, where the common bile duct drains into the pancreatic duct main, forming a common duct; and P-B type, where the main pancreatic duct drains into the bile duct, forming a common duct [11,13,34,37]. Other variations in the pancreatic ducts have been described.…”