Patency of the Human Accessory Pancreatic Duct as Determined by Dye-Injection Endoscopic Retrograde Pancreatography

Kamisawa, Terumi; Tabata, I; Tajima, Tsuyoshi; Tsushima, K; Y, Yoshida

doi:10.1159/000201427

Cited by 35 publications

(42 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Long inferior branches exceeding 2 cm and passing through the MPD to the caudal portion were examined. The terminal portions of the APD could be classified radiologically into stick, branch, saccular, spindle or cudgel types [8, 9]. …”

Section: Methodsmentioning

confidence: 99%

“…After conventional ERP, we performed the dye injection ERP [8, 9]to evaluate the function of the APD in 109 patients in whom the MPD could be selectively cannulated and a pancreatogram of the fine branches could be obtained. First, 2 or 3 ml of contrast medium containing indigo carmine were injected through a catheter into the MPD with the usual injection pressure.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Embryology of the Pancreatic Duct System

Kamisawa

Koike²,

Okamoto³

1999

Digestion

Self Cite

View full text Add to dashboard Cite

Background/Aims: It has been suggested that the distal portion of the dorsal pancreatic duct and the ventral pancreatic duct usually merge into the main pancreatic duct, and the proximal portion of the dorsal pancreatic duct becomes the accessory pancreatic duct. In this study, we investigated the embryology of the accessory pancreatic duct roentgenographically and immunohistochemically. Methods/Results: The accessory pancreatic duct shows two different patterns in pancreatograms: the long and the short type. The accessory pancreatic duct of the long type forms a straight line and joins the main pancreatic duct at the neck portion of the pancreas. The accessory pancreatic duct of the short type joins the main pancreatic duct near its first inferior branch. Long inferior branches from the accessory pancreatic duct were found in 74.6% with the long type, significantly more often than in the short type (29.3%). Patency of the long type was (74.5%) significantly greater than in the short type (36.2%). Immunohistochemically, we found the main pancreatic duct between the junction with the accessory pancreatic duct and the neck portion of the autopsy pancreas in the short type was located within the ventral pancreas, characterized by pancreatic polypeptide-rich islets. Conclusion: The long type represents a continuation of the main duct of the dorsal primordium. The short type is very likely formed by the proximal main duct of the dorsal primordium and its long inferior branch, with the main duct of the dorsal primordium at the point of connection with the main duct of the ventral primordium being obliterated and replaced by this additional communication.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Embryology of the Pancreatic Duct System

Kamisawa

Koike²,

Okamoto³

1999

Digestion

Self Cite

View full text Add to dashboard Cite

show abstract

“…The spindle- and cudgel-type APD showed higher patency, but the branch- and saccular-type APD showed lower patency than the stick-type APD. We also found that patency of the APD in patients with acute pancreatitis was significantly lower than in controls [5,6,7]. …”

Section: Discussionmentioning

confidence: 93%

“…Using dye injection ERP, we previously demonstrated the close relationship between the terminal shape of the APD and its patency in 291 control cases. We also found that patency of the APD was significantly lower in 46 patients with acute pancreatitis than in controls [5,6,7]. To examine whether patency of the APD prevents post-ERCP pancreatitis, we retrospectively determined patency of the APD in patients with post-ERCP pancreatitis based on the previous data by dye injection ERP.…”

Section: Introductionmentioning

confidence: 99%

A Patent Accessory Pancreatic Duct Prevents Pancreatitis following Endoscopic Retrograde Cholangiopancreatography

Tabata

Kamisawa²,

Takuma³

et al. 2010

Dig Surg

Self Cite

View full text Add to dashboard Cite

Background/Aim: Pancreatitis is the most common and feared complication of endoscopic retrograde cholangiopancreatography (ERCP). We previously examined patency of the accessory pancreatic duct (APD) by dye injection endoscopic retrograde pancreatography (ERP). APD patency was found in 43% of 291 control cases who had no particular changes in the head of the pancreas compared to only 6% in patients with acute pancreatitis. APD patency was closely related with the shape of the terminal portion of the APD. This study aimed to clarify whether patency of the APD prevents post-ERCP pancreatitis. Methods:We examined retrospectively the terminal shape of the APD by ERP in 34 patients with post-ERCP pancreatitis. Based on these data, patency of the APD was estimated from its terminal shape in patients with post-ERCP pancreatitis. Results: The stick-type APD (p < 0.01), which indicated high patency, was less frequent, and the branch-type APD (p < 0.01) and halfway-type APD, or no APD (p < 0.01), which showed quite low patency, were more frequent in patients with post-ERCP pancreatitis compared with controls. Accordingly, the estimated patency of the APD in post-ERCP pancreatitis patients was only 16%, which was significantly lower than the 43% in controls. There was no significant relationship between the estimated APD patency and the severity of post-ERCP pancreatitis. Conclusions: The estimated APD patency was significantly lower in patients with post-ERCP pancreatitis. A patent APD may function as a second drainage system to reduce the pressure in the main pancreatic duct and prevent post-ERCP pancreatitis.

show abstract

“…We have prospectively studied the anatomy of the pancreatic duct system using endoscopic retrograde pancreatography [6,7,8,9]. To achieve optimal visualization, several pancreatograms of the head of the pancreas were taken with the patient in the prone or slightly oblique position.…”

Section: Methodsmentioning

confidence: 99%

A New Embryological Theory of the Pancreatic Duct System

Kamisawa¹,

Takuma²,

Egawa³

et al. 2010

Dig Surg

Self Cite

View full text Add to dashboard Cite

Background/Aims: To clarify the anatomy of the pancreatic duct system and to investigate its embryology. Methods: We reviewed pancreatograms of 256 patients with a normal pancreatic head and 36 cases of complete pancreas divisum. Results: Accessory pancreatograms were divided into two patterns. The long-type accessory pancreatic duct (APD) forms a straight line and joins the main pancreatic duct (MPD) at the neck portion of the pancreas. The short-type APD joins the MPD near its first inferior branch. The short-type APD is less likely to have a long inferior branch arising from the APD. The length of the APD from the orifice to the first long inferior branch was similar in the short- and long-type APD. The first long inferior branch from the long-type APD passes through the MPD near the origin of the inferior branch from the MPD. Immunohistochemically, in the short-type APD, the MPD between the junction of the short-type APD and the neck portion originated from the ventral pancreas. Conclusion: The long-type APD represents a continuation of the main duct of the dorsal pancreatic bud. The short-type APD is very likely formed by the proximal main duct of the dorsal pancreatic bud and its long inferior branch, with the main duct of the dorsal pancreatic bud at the point of connection with the main duct of the ventral pancreatic bud being obliterated and replaced by this additional communication.

show abstract

Patency of the Human Accessory Pancreatic Duct as Determined by Dye-Injection Endoscopic Retrograde Pancreatography

Cited by 35 publications

References 4 publications

Embryology of the Pancreatic Duct System

Embryology of the Pancreatic Duct System

A Patent Accessory Pancreatic Duct Prevents Pancreatitis following Endoscopic Retrograde Cholangiopancreatography

A New Embryological Theory of the Pancreatic Duct System

Contact Info

Product

Resources

About