Pancreatic ducts
Updates to Article Attributes
The pancreatic ductal embryology is moderately complicated, leading to a number of anatomical variants of the pancreatic ducts, many of which are clinically significant.
The normal arrangement is for the entire pancreas to be drained via a single duct, to the ampulla of Vater through the sphincter of Oddi.
Conventional pancreatic ductal anatomy
Main pancreatic duct
- portion of the dorsal duct proximal to the dorsal-ventral fusion point
- drains at the ampulla of Vater
- connects with the duct of Santorini (see below) if present
Pancreatic duct of Wirsung
- segment of the ventral duct between the dorsal-ventral fusion point and the major papilla
- continuous with the main pancreatic duct
Accessory pancreatic duct (of Santorini)
- portion of thedorsal duct distal to the dorsal-ventral fusion point
- drains anterior and superior portion of the head
- in 70% of individuals drains
atto the minor papilla - in 30% of individuals persists as a branch of the main pancreatic duct
- in 70% of individuals drains
Variant anatomy
Variants of the pancreas, which result in ductal variations are covered in the pancreas article.
Pancreas divisum
Apancreas divisum is the most common variation of pancreatic duct formation and can account for up to 14% 3. It results from failure of fusion of dorsal and ventral pancreatic anlages. As a result, the dorsal pancreatic duct drains most of the pancreatic glandular parenchyma via glandular parenchyma via the minor papilla. Although controversial, this variant is considered as a cause of pancreatitis1,3.
Pancreatic divisum can result in asantorinicele2, which is a cystic dilatation of the distal dorsal duct, immediately proximal to the minor papilla .
Three subtypes are known5:
- type 1: classic, no connection at all; occurs in the majority of cases (~70%)
- type 2: absent ventral duct, minor papilla drainall of pancreas while major papilla drains bile duct (~25%)
- type 3: functional, filamentous or inadequate connection between dorsal and ventral ducts (~5%)
Meandering main pancreatic duct
Meandering main pancreatic duct (MMPD) comprises of a reverse Z-type and loop-type of pancreatic ducts.
Ansa pancreatica
Ansa pancreatica pancreatica is a rare anatomic variation of the pancreatic ducts. It is a communication between the main pancreatic duct and the accessory pancreatic duct.
Anomalous pancreaticobiliary junction
Anomalous pancreaticobiliary junction refers to the union of the pancreatic duct and common bile duct outside the duodenal wall.
History and etymology
The duct of Wirsung was first reported in an etching by Johann Georg Wirsung (1589-1643), a German-Italian anatomist 8.
The accessory pancreatic duct of Santorini Santorini is named afterGiovanni Domenico Santorini (1681-1737), an Italian professor of medicine 8.
-<li>portion of the <strong>dorsal duct </strong>distal to the dorsal-ventral fusion point </li>- +<li>portion of the <strong>dorsal duct </strong>distal to the dorsal-ventral fusion point </li>
-<li>in 70% of individuals drains at the minor papilla</li>- +<li>in 70% of individuals drains to the minor papilla</li>
-</ul><h4>Variant anatomy</h4><p>Variants of the pancreas, which result in ductal variations are covered in the <a href="/articles/pancreas">pancreas</a> article. </p><h5>Pancreas divisum</h5><p>A <a href="/articles/pancreas-divisum">pancreas divisum</a> is the most common variation of pancreatic duct formation and can account for up to 14% <sup>3</sup>. It results from failure of fusion of dorsal and ventral pancreatic anlages. As a result, the dorsal pancreatic duct drains most of the pancreatic glandular parenchyma via the minor papilla. Although controversial, this variant is considered as a cause of pancreatitis <sup>1,3</sup>. </p><p>Pancreatic divisum can result in a <a href="/articles/santorinicoele">santorinicele </a><sup>2</sup>, which is a cystic dilatation of the distal dorsal duct, immediately proximal to the minor papilla . </p><p>Three subtypes are known <sup>5</sup>:</p><ul>- +</ul><h4>Variant anatomy</h4><p>Variants of the pancreas which result in ductal variations are covered in the <a href="/articles/pancreas">pancreas</a> article. </p><h5>Pancreas divisum</h5><p>A <a href="/articles/pancreas-divisum">pancreas divisum</a> is the most common variation of pancreatic duct formation and can account for up to 14% <sup>3</sup>. It results from failure of fusion of dorsal and ventral pancreatic anlages. As a result, the dorsal pancreatic duct drains most of the pancreatic glandular parenchyma via the minor papilla. Although controversial, this variant is considered as a cause of pancreatitis <sup>1,3</sup>. </p><p>Pancreatic divisum can result in a <a href="/articles/santorinicoele">santorinicele </a><sup>2</sup>, which is a cystic dilatation of the distal dorsal duct, immediately proximal to the minor papilla . </p><p>Three subtypes are known <sup>5</sup>:</p><ul>
-<strong>type 2:</strong> <strong>absent ventral duct,</strong> minor papilla drain <strong>all</strong> of pancreas while major papilla drains bile duct (~25%)</li>- +<strong>type 2:</strong> <strong>absent ventral duct,</strong> minor papilla drain <strong>all</strong> of pancreas while major papilla drains bile duct (~25%)</li>
-</ul><h5>Meandering main pancreatic duct</h5><p><a href="/articles/meandering-main-pancreatic-duct">Meandering main pancreatic duct (MMPD)</a> comprises of a reverse Z-type and loop-type of pancreatic ducts.</p><h5>Ansa pancreatica</h5><p><a href="/articles/ansa-pancreatica">Ansa pancreatica</a> is a rare anatomic variation of the pancreatic ducts. It is a communication between the main pancreatic duct and the accessory pancreatic duct.</p><h5>Anomalous pancreaticobiliary junction</h5><p><a href="/articles/anomalous-pancreaticobiliary-junction">Anomalous pancreaticobiliary junction</a> refers to the union of the pancreatic duct and common bile duct outside the duodenal wall. </p><h4>History and etymology</h4><p>The <strong>duct of Wirsung</strong> was first reported in an etching by <strong>Johann Georg Wirsung</strong> (1589-1643), a German-Italian anatomist <sup>8</sup>. </p><p>The <strong>accessory pancreatic duct of Santorini </strong>is named after <strong>Giovanni Domenico Santorini </strong>(1681-1737), an Italian professor of medicine <sup>8</sup>. </p>- +</ul><h5>Meandering main pancreatic duct</h5><p><a href="/articles/meandering-main-pancreatic-duct">Meandering main pancreatic duct (MMPD)</a> comprises of a reverse Z-type and loop-type of pancreatic ducts.</p><h5>Ansa pancreatica</h5><p><a href="/articles/ansa-pancreatica">Ansa pancreatica</a> is a rare anatomic variation of the pancreatic ducts. It is a communication between the main pancreatic duct and the accessory pancreatic duct.</p><h5>Anomalous pancreaticobiliary junction</h5><p><a href="/articles/anomalous-pancreaticobiliary-junction">Anomalous pancreaticobiliary junction</a> refers to the union of the pancreatic duct and common bile duct outside the duodenal wall. </p><h4>History and etymology</h4><p>The <strong>duct of Wirsung</strong> was first reported in an etching by <strong>Johann Georg Wirsung</strong> (1589-1643), a German-Italian anatomist <sup>8</sup>. </p><p>The <strong>accessory pancreatic duct of Santorini </strong>is named after <strong>Giovanni Domenico Santorini </strong>(1681-1737), an Italian professor of medicine <sup>8</sup>. </p>
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