The mucosal folds at the pancreaticobiliary junction

Abstract

This study demonstrates that the mucosal folds of the terminal bile and pancreatic ducts contain muscle and nerve fibres, suggesting an active rather than purely passive function.

A novel concept of passive loop-forming wire-guided biliary cannulation using an ultra-deep angled tip guidewire (with video)

“…These folds were distributed over a mean distance of 7.3 mm along the NDS. In addition, the closer the orifice is, the higher these folds grow 5 . Based on these anatomical structures, the guidewire obstruction could develop within 10 mm from the Vater's orifice.…”

“…The exclusion criteria comprised patients (1) aged <20 years, (2) with surgically altered gastrointestinal anatomy (excluding Billroth I reconstruction), (3) with a history of endoscopic sphincterotomy (EST)/endoscopic papillary large balloon dilation, (4) with a papilla of Vater with tumor invasion, (5) with gallstone pancreatitis in the active phase, (6) who underwent direct precutting, (7) with duodenoscope intubation failure, and (8) who were deemed ineligible owing to other reasons.…”

“…grow [5]. Based on these anatomical structures, the guidewire obstruction could develop within 10 mm from the Vater's orifice.…”

“…Considering the papilla of Vater, WGBC can be achieved in two steps: 1) selection of the biliary narrow distal segment (NDS) at the biliary-pancreatic bifurcation; and 2) advancement of the guidewire through the NDS. The NDS, which includes dense inner mucosal folds as check valves, may have a reverse-S or N shape 3 4 5 . Although previous studies have focused on the characteristics of the guidewire used for WGBC, a dedicated guidewire has not been established 6 7 8 9 .…”

The distribution and chemical coding of neurons supplying the sphincter of Oddi in mammals

“…The anatomy of the MDP is relatively well recognized, especially in laboratory mammals and man, although its structural organization differs considerably between species. Nevertheless, it usually represents a slight elevation on the intestinal mucosa where the dilated junction (ampulla of Vater) of the commmon bile denal contents, bile and pancreatic juice into the bile and pancreatic ducts (Funch-Jensen 1990, Woods et al 2005, Purvis et al 2013.…”