Variations in the Pancreatic Ducts and the Minor Duodenal Papilla.*

Simkins, Samuel

doi:10.1097/00000441-193118250-00004

Cited by 8 publications

(11 citation statements)

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“…Pancreatitis may be localized to that portion of the pancreas drained by the duct of Santorini (Opie, 299 A. D. McCutcheon 1910;Colp, 1930;Simkins, 1931;Dragstedt et al, 1934;Warren and Cattell, 1956). Opie and Meakin (1909) described such a case in an alcoholic patient and the only part of the pancreas which was normal was the small area drained by the duct of Wirsung.…”

mentioning

confidence: 99%

A fresh approach to the pathogenesis of pancreatitis.

McCutcheon¹

1968

Gut

129

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mentioning

confidence: 99%

A fresh approach to the pathogenesis of pancreatitis.

McCutcheon¹

1968

Gut

129

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“…Patency of the APD has been assessed by direct injection of material into the pancreatic duct in resected or autopsy specimens [18][19][20] . A great deal of difficulty is encountered in determining the percentage of cases in which the MIP is patent.…”

Section: Introductionmentioning

confidence: 99%

“…A great deal of difficulty is encountered in determining the percentage of cases in which the MIP is patent. Accordingly, the reported patency of the APD has ranged widely from 12% [18] to 82% [19] . Clinical significance of the APD in the typical pancreatic duct system with fusion between the ventral and DPD remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Clinical implications of accessory pancreatic duct

Kamisawa¹,

Takuma²,

Tabata³

et al. 2010

WJG

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The accessory pancreatic duct (APD) is the main drainage duct of the dorsal pancreatic bud in the embryo, entering the duodenum at the minor duodenal papilla (MIP). With the growth, the duct of the dorsal bud undergoes varying degrees of atrophy at the duodenal end. Patency of the APD in 291 control cases was 43% as determined by dye-injection endoscopic retrograde pancreatography. Patency of the APD in 46 patients with acute pancreatitis was only 17%, which was significantly lower than in control cases (P < 0.01). The terminal shape of the APD was correlated with APD patency. Based on the data about correlation between the terminal shape of the APD and its patency, the estimated APD patency in 167 patients with acute pancreatitis was 21%, which was significantly lower than in control cases (P < 0.01). A patent APD may function as a second drainage system for the main pancreatic duct to reduce the pressure in the main pancreatic duct and prevent acute pancreatitis. Pancreatographic findings of 91 patients with pancreaticobiliary maljunction (PBM) were divided into a normal duct group (80 patients) and a dorsal pancreatic duct (DPD) dominant group (11 patients). While 48 patients (60%) with biliary carcinoma (gallbladder carcinoma, n = 42; bile duct carcinoma, n = 6) were identified in PBM with a normal pancreatic duct system, only two cases of gallbladder carcinoma (18%) occurred in DPD-dominant patients (P < 0.05). Concentration of amylase in the bile of DPD dominance was significantly lower than that of normal pancreatic duct system (75 403.5 ± 82 015.4 IU/L vs 278 157.0 ± 207 395.0 IU/L, P < 0.05). In PBM with DPD dominance, most pancreatic juice in the upper DPD is drained into the duodenum via the MIP, and reflux of pancreatic juice to the biliary tract might be reduced, resulting in less frequency of associated biliary carcinoma.

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“…On the other hand, Santorini’s duct dominance, in which the ventral pancreatic duct is narrower than and anastomoses with Santorini’s duct, is observed in 1–8% of pancreases [3, 4, 5, 6]. However, few detailed studies have been performed about this anomaly.…”

Section: Introductionmentioning

confidence: 99%

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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Variations in the Pancreatic Ducts and the Minor Duodenal Papilla.*

Cited by 8 publications

References 0 publications

A fresh approach to the pathogenesis of pancreatitis.

A fresh approach to the pathogenesis of pancreatitis.

Clinical implications of accessory pancreatic duct

Clinical and Radiological Findings in Dominance of Santorini’s Duct

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