Anatomic variations of the pancreatic duct and their relevance with the Cambridge classification system: MRCP findings of 1158 consecutive patients

Abstract

BackgroundThe study was conducted to evaluate the frequencies of the anatomic variations and the gender distributions of these variations of the pancreatic duct and their relevance with the Cambridge classification system as morphological sign of chronic pancreatitis using magnetic resonance cholangiopancreatography (MRCP).Patients and methodsWe retrospectively reviewed 1312 consecutive patients who referred to our department for MRCP between January 2013 and August 2015. We excluded 154 patients from the study because of less than optimal results due to imaging limitations or a history of surgery on pancreas. Finally a total of 1158 patients were included in the study.ResultsAmong the 1158 patients included in the study, 54 (4.6%) patients showed pancreas divisum, 13 patients (1.2%) were defined as ansa pancreatica. When we evaluated the course of the pancreatic duct, we found the prevalence 62.5% for descending, 30% for sigmoid, 5.5% for vertical and 2% for loop. The most commonly observed pancreatic duct configuration was Type 3 in 528 patients (45.6%) where 521 patients (45%) had Type 1 configuration.ConclusionsVertical course (p = 0.004) and Type 2 (p = 0.03) configuration of pancreatic duct were more frequent in females than males. There were no statistically significant differences between the gender for the other pancreatic duct variations such as pancreas divisium, ansa pancreatica and course types other than vertical course (p > 0.05 for all). Variants of pancreas divisum and normal pancreatic duct variants were not associated with morphologic findings of chronic pancreatitis by using the Cambridge classification system. The ansa pancreatica is a rare type of anatomical variation of the pancreatic duct, which might be considered as a predisposing factor to the onset of idiopathic pancreatitis.

The anatomical variations of pancreatic duct in the patients with pancreatic diseases

“…The results of our analysis are similar to those presented in current literature [1][2]11]. The most common variants of the MPD in our sample were pancreas divisum and ansa pancreatica.…”

“…The total number of anatomic variations in general population is low, but in patients suffering from pancreatic diseases this rate is much higher [1][2][3][4]11]. According to the current literature, pancreas divisum is the most common anatomic variant of pancreatic duct in the general population [11]. It is caused by a failure to fuse the ventral and dorsal ducts of the embryonic pancreas during embryonic development [1,[11][12][13].…”

“…According to the current literature, pancreas divisum is the most common anatomic variant of pancreatic duct in the general population [11]. It is caused by a failure to fuse the ventral and dorsal ducts of the embryonic pancreas during embryonic development [1,[11][12][13]. The patients with complete pancreas divisum have no junction between the dorsal and ventral pancreatic ducts [1,[11][12].…”

“…It is caused by a failure to fuse the ventral and dorsal ducts of the embryonic pancreas during embryonic development [1,[11][12][13]. The patients with complete pancreas divisum have no junction between the dorsal and ventral pancreatic ducts [1,[11][12]. On the other hand, patients with incomplete pancreas divisum usually have small communicating branch between dorsal and ventral pancreatic ducts [1,12].…”

A study of the anatomic variations of the pancreatico-biliary system in Palestine: a national study

“…Results showed 62.5% for descending versus 75.4% at our present study, 30% for sigmoid versus 18.7% at our present study, 5.5% for vertical versus 4.4% at our present study and 2% for loop versus 1.2% at our present study. 27 In Korea, a study was carried out to detect anomalies of the pancreaticobiliary ducts of Koreans. Choledocal cyst was identified in 0.32% of its cases versus 1.2% in the current study.…”