Anatomy of the Pancreatic Duct A Duodenoscopic-Radiological Study

Classen, Meinhard; Hellwig, H.; Rösch, Wolfgang

doi:10.1055/s-0028-1098203

Cited by 41 publications

(10 citation statements)

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“…Although the width may be affected by age, variation should not be greater than 1mm in each part of the pancreas [7,8] . The width of the main pancreatic duct is similar in population groups studied, such as in Europe, Asia, and America [9][10][11][12] . Furthermore, it is believed that bile duct dilation may occur after cholecystectomy, however, there are no enough data to support this.…”

Section: Discussionmentioning

confidence: 99%

Clinical significance of main pancreatic duct dilation on computed tomography: Single and double duct dilation

Edge

Hoteit²,

Patel³

et al. 2007

WJG

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AIM:To study the patients with main pancreatic duct dilation on computed tomography (CT) and thereby to provide the predictive criteria to identify patients at high risk of significant diseases, such as pancreatic cancer, and to avoid unnecessary work up for patients at low risk of such diseases. METHODS:Patients with dilation of the main pancreatic duct on CT at Emory University Hospital in 2002 were identified by computer search. Clinical course and ultimate diagnosis were obtained in all the identified patients by abstraction of their computer database records. RESULTS:Seventy-seven patients were identified in this study. Chronic pancreatitis and pancreatic cancer were the most common causes of the main pancreatic duct dilation on CT. Although the majority of patients with isolated dilation of the main pancreatic duct (single duct dilation) had chronic pancreatitis, one-third of patients with single duct dilation but without chronic pancreatitis had pancreatic malignancies, whereas most of patients with concomitant biliary duct dilation (double duct dilation) had pancreatic cancer. CONCLUSION:Patients with pancreatic double duct dilation need extensive work up and careful followup since a majority of these patients are ultimately diagnosed with pancreatic cancer. Patients with single duct dilation, especially such patients without any evidence of chronic pancreatitis, also need careful follow-up since the possibility of pancreatic malignancy, including adenocarcinoma and intraductal papillary mucinous tumors, is still high.© 2007 The WJG Press. All rights reserved.

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Section: Discussionmentioning

confidence: 99%

Clinical significance of main pancreatic duct dilation on computed tomography: Single and double duct dilation

Edge

Hoteit²,

Patel³

et al. 2007

WJG

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“…ERCP development has contributed much to the diagnosis of biliary and pancreatic diseases and, more importantly, to the study of anatomical morphology and structure which were previously dependent on autopsy and surgery. Normally, the morphology and size of the pancreatic duct and duodenal papilla of each person are different, and accordingly, many diagnostic references have been reported by many researchers on normal pancreatography 3 , 4 , 6 , 7 ) .…”

Section: Discussionmentioning

confidence: 99%

“…The proximal MPD has been shown by rotentgenography to be consistently located at the level of the second lumbar verbetra. 3 )…”

Section: Discussionmentioning

confidence: 99%

“…For the purpose of increasing ERCP usage along with exact diagnosis and early detection of local disease, our own clear understanding and precise knowledge of normal pancreatographic features is essential. However, most of the papers on pancreatic features have been reported by foreign authors 2 , 3 , 4 , 5 ) . Therefore, we examined pancreatic morphology by analyzing the normal pancreatographic features of persons without pancreatic diseases at Yonsei Medical Center and made diagnostic references for normal pancreatic features of Koreans in general.…”

Section: Introductionmentioning

confidence: 99%

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The Normal Endoscopic Pancreatogram in Koreans

Kang

Chung

Moon

et al. 1989

Korean J Intern Med

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The establishment of endoscopic retrograde cholangiopancreatography (ERCP) as a valuable procedure in diagnostic evaluation of patients with suspected pancreatic disease requires the precise delineation of normal pancreatography. Therefore, to establish normal standards in Koreans of pancreatic ductal morphology, such as course, diameter and length including the shape of the ampulla and the success rate of the ERCP procedure, we analyzed the pancreatograms of persons with proven normal pancreatic status. Of the 449 cases showing normal duodenal papilla, the hemispherical type of shape (49.7%) was the most common, followed by the papillary type (36.5 %) and flat type (13.8%) in order of frequency. The success rate of ERCP procedure (1,020 cases) was 95.3%, and the selective success rate was 90.9% for the panceatic duct and 79.3% for the biliary tree. In the course of the pancreatic duct (286 cases), the ascending type of extension (51.7%) was the most common followed by the sigmoid type (25.2%), horizontal type (22.4%) and descending type (0.7%). The diameter of the pancreatic duct was 3.3 ± 0.8mm in the head, 2.4 ± 0.5mm in the body and 1.5 ± 0.5mm in the tail portion, and there was a tendency that the diameter of the pancreatic duct progressively increased with age. The length of the pancreatic duct was 17.5 ± 2.8cm. In conclusion we hope that, by utilizing these various parameters of the normal endoscopic retrograde pancreatogram, precise diagnosis will be possible.

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“…ERCP has provided us with reference sources enabling us to appreciate the normal pancreatic anatomy and its variations as well as pathologic changes that occur [10,[20][21][22][23][24]. The appreciation of inflammatory changes has given us a better understanding of the insidious progression of chronic pancreatitis and its intercurrent consequences.…”

Section: Inflammatorymentioning

confidence: 99%

ERCP update: Diagnostic and therapeutic applications

Siegel

1978

Gastrointest Radiol

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Endoscopic retograde cholangiopancreatography (ERCP) is currently utilized to evaluate jaundice, both intra- and extrahepatic, and can differentiate between these by demonstrating specific anatomic lesions. ERCP is definitive in the evaluation of gallbladder disease when other modalities are indefinite. For the first time outside the operating room, the pancreatic duct can be opacified by ERCP. The newest application of ERCP, endoscopic papillotomy (EP), has revolutionized the treatment of common bile duct gallstones and stenosis of the duct, offering a safe and effective alternative to repeated surgery, especially in those patients at risk. Because of these diverse and effective applications, ERCP has become firmly established in our diagnostic armamentarium.

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Anatomy of the Pancreatic Duct A Duodenoscopic-Radiological Study

Cited by 41 publications

References 1 publication

Clinical significance of main pancreatic duct dilation on computed tomography: Single and double duct dilation

Clinical significance of main pancreatic duct dilation on computed tomography: Single and double duct dilation

The Normal Endoscopic Pancreatogram in Koreans

ERCP update: Diagnostic and therapeutic applications

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