The Main Anatomical Variations of the Pancreatic Duct System: Review of the Literature and Its Importance in Surgical Practice

Dimitriou, Ioannis; Katsourakis, Anastasios; Nikolaidou, Eirini; Noussios, George

doi:10.14740/jocmr3344w

Cited by 36 publications

(48 citation statements)

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“…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.…”

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confidence: 88%

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

et al. 2019

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Introduction Morphological variants of the pancreatobiliary system can predispose to chronic pancreatitis. The goal of the present study is to assess the prevalence of pancreatic duct patterns in the Indian population, both by cadaveric dissection and by magnetic resonance cholangiopancreatography (MRCP). Materials and Methods A total of 15 adult pancreas specimens of unknown age and gender, and 5 fetal pancreas specimens of different gestational ages with the intact second part of duodenum, were dissected by the piecemeal method. For clinical relevance, MRCP images of 103 clinically-diagnosed chronic pancreatitis patients irrespective of their etiology were obtained retrospectively from the existing database and studied. The anatomical patterns were classified as five different types based on the course of the main pancreatic duct and the accessory pancreatic duct and their openings into the duodenal wall, including variants like pancreas divisum and ansa pancreatica. Results In the cadaveric study, the main pancreatic duct was single with a straight course in 46.67% of the adult specimens, and in the MRCP study, the main pancreatic duct showed a descending course in 77.66% of the cases. The most common pattern was type III in both the cadaveric (80%) and radiological (55.33%) studies, and the accessory duct was absent on the MRCP in all type-III cases, while it ended blindly in the cadaveric specimens. Ansa pancreatica (type V) was observed in 1 adult specimen (6.7%), but not in the radiological study. Pancreas divisum (type IV) was observed in the 8 cases (7.76%) cases in the radiological study. Conclusion Knowledge of the anatomical variants of the pancreatic ductal system may be helpful for the radiologists during diagnostic and therapeutic interventional procedures.

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confidence: 88%

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

et al. 2019

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“…A widely accepted classification system for pancreatic ductal configuration recognizes five classes of ductal configuration ( Figure 2) [8].…”

Section: Pancreatic Duct Configuration Variationsmentioning

confidence: 99%

“…Types 1, 2 and 3 are regarded as 'normal' anatomy [15]. A recent systematic review that analyzed the pancreatic duct anatomy of 8,260 individuals found normal anatomy (types 1-3) in 94.3% of the cases, pancreas divisum (type 4) in 4.5%, and ansa pancreatica (type 5) in 0.25% of individuals [8].…”

Section: Figure 2: Pancreatic Duct Configurationsmentioning

confidence: 99%

“…While much focus has been on patient factors such as the age, gender, and sphincter of Oddi dysfunction in the occurrence of PEP, the impact of pancreatic duct variations on the risk of developing PEP has remained a subject of debate. Pancreatic duct variations are relatively common, occurring in 5.7% of the population [8]. Many of these variations have been associated with pathologies such as acute pancreatitis, chronic pancreatitis, and pancreatic tumors [9,10].…”

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confidence: 99%

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Pancreatic Duct Variations and the Risk of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis

Ojo

2020

Cureus

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Endoscopic retrograde cholangiopancreatography (ERCP) is an important diagnostic and therapeutic procedure in the management of biliary and pancreatic disorders. Despite advances in ERCP facilities and techniques, pancreatitis remains the most common and feared complication of this procedure. The technical challenges of ERCP could be further compounded by variations in the configuration of the pancreatic ductal system. As a result, the knowledge of these variations and their potential role in the development of post-ERCP pancreatitis (PEP) is essential to any successful risk reduction strategy. This review provides an overview of the anatomy and embryological basis of pancreatic duct variations, as well as explore the different types and prevalence of these variations. Also, we discuss the mechanisms of PEP and provide evidence supporting a link between the variations and PEP using published data

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“…Some authors call Santorini duct as regressed proximal main duct of dorsal pancreatic bud [4]. Recent review papers of pancreatic anatomy also give unclear description: "The ventral pancreatic duct and the distal part of the dorsal pancreatic duct are anastomosed and form the MPD of Wirsung, while the proximal part of the dorsal pancreatic duct becomes the APD of Santorini" [2]. This few examples show dual benchmark related to pancreatic gland.…”

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Pancreatic theory of relativity...

Hać

2019

Folia Morphol

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The Main Anatomical Variations of the Pancreatic Duct System: Review of the Literature and Its Importance in Surgical Practice

Cited by 36 publications

References 23 publications

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

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

Pancreatic Duct Variations and the Risk of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis

Pancreatic theory of relativity...

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