Cadaveric Study of the Anatomical Variations of the Accessory Pancreatic Duct

Abstract

Background: The accessory pancreatic duct enters the duodenum at the minor duodenal papilla, developmentally draining the dorsal pancreatic bud; however, it is smaller and less constant than the main pancreatic duct and undergoes varying degrees of atrophy at the duodenal end. Objective: The objective of this study was to see the variations in course, opening and communication pattern of the accessory pancreatic duct in different age-groups in a Bangladeshi population. Methods: This crosssectional, descriptive study was done was done in the Department of Anatomy, Dhaka Medical College, Dhaka, from August 2005 to December 2006, based on collection and dissection of 75 postmortem male human pancreas. The collected samples were divided into seven age groups: 10-19 years, 20-29 years,30-39 years, 40-49 years, 50-59 years),60-69 years and(eˆ70 years. However, 65 samples were taken for final observation. Results: The accessory pancreatic duct was found in 27.69% specimens. Straight course was found in 50% specimen, while spindle course in 27.78% and cudgel course in 22.22% specimens were observed. In only 4 (6.15%) specimens, the accessory pancreatic duct communicates with the common bile duct, while in 11 (16.93%) specimens, the accessory pancreatic duct communicates with the main pancreatic duct. 12 (66.67%) accessory pancreatic ducts opened into the minor duodenal papilla, while 5 (27.78%) into the major duodenal papilla and 1 (5.55%) into the 3 rd duodenal papilla. Conclusion: Several variations were observed in accessory pancreatic duct pattern in terms of their course, opening and communications. However, no significant differences were evident in any parameter among the age groups. Here, females were excluded due to less availability of the female cadaveric pancreas during study period.

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

“…Türkvatan et al 8 classified the pancreatic ductal system into five types, and reported that the most common type was the MPD (type I) followed by the absent APD (type III). In the present study, type III was the predominant type, which is similar to the studies by Dawson and Langman, 2 Sunjida Shahriah et al, 3 Adibelli et al, 7 and Bülow et al 17 In a literature review on the main anatomical variations of the pancreatic duct system by Dimitriou et al, 18 a total of 8,260 patients were analyzed. In their study, 94.3% of the cases displayed normal anatomy (types I-III), 4.5% had pancreas divisum, and 1.2% were reported as having rare anomalies.…”

“…In their study, 94.3% of the cases displayed normal anatomy (types I-III), 4.5% had pancreas divisum, and 1.2% were reported as having rare anomalies. Sunjida Shahriah et al 3 reported that type III was the most common type (72.3%) observed, as well as Adibelli et al, 7 and Bülow et al, 17 who reported prevalences of 63% and 45.6% respectively.…”

“…The anatomical variations of the accessory pancreatic duct (APD) were studied by dissection in terms of its shape, course, opening into the duodenum, patency and communication with the main pancreatic duct (MPD). 3,4 Sunjida Shahriah et al 3 studied in detail the course of the APD (describing it as straight, spindle and cudgel) and its communication with the MPD radiologically using Barium X-ray.…”

“…The studies reported different incidences of the APD. Dawson and Langman 2 reported it as 92% in the North American population; Sunjida Shahriah et al, 3 as 27.69% in Bangladesh; and Wilasrusmee and Pongchaicherks, 24 as 57.26% in Thailand. In the present cadaveric study, the incidence was of 66.67%, and it was of 41.74% in the radiological study.…”

“…In the present cadaveric study, the incidence was of 66.67%, and it was of 41.74% in the radiological study. As for the communication of the APD with the MPD, Dawson and Langman 2 reported a rate of 77.7%, and Sunjida Shahriah et al, 3 a rate of 16.93%. Double, triple and quadruple communications have been reported in another study.…”