{"id":1724,"date":"2019-02-05T13:15:38","date_gmt":"2019-02-05T13:15:38","guid":{"rendered":"http:\/\/www.ijmhr.org\/IntJAnatRes\/?page_id=1724"},"modified":"2019-02-05T13:15:38","modified_gmt":"2019-02-05T13:15:38","slug":"ijar-2018-424","status":"publish","type":"page","link":"https:\/\/www.ijmhr.org\/IntJAnatRes\/ijar-2018-424","title":{"rendered":"IJAR.2018.424"},"content":{"rendered":"<div class=\"su-row\"><div class=\"su-column su-column-size-1-2\"><div class=\"su-column-inner su-u-clearfix su-u-trim\"><div class=\"su-button-center\"><a href=\"https:\/\/www.ijmhr.org\/ijar.7.1\/IJAR.2018.424.pdf\" class=\"su-button su-button-style-default\" style=\"color:#FFFFFF;background-color:#6b0e00;border-color:#560c00;border-radius:5px;-moz-border-radius:5px;-webkit-border-radius:5px\" target=\"_self\"><span style=\"color:#FFFFFF;padding:6px 16px;font-size:13px;line-height:20px;border-color:#98574d;border-radius:5px;-moz-border-radius:5px;-webkit-border-radius:5px;text-shadow:none;-moz-text-shadow:none;-webkit-text-shadow:none\"><i class=\"sui sui-cloud-download\" style=\"font-size:13px;color:#FFFFFF\"><\/i> DOWNLOAD PDF<\/span><\/a><\/div><\/div><\/div> <div class=\"su-column su-column-size-1-2\"><div class=\"su-column-inner su-u-clearfix su-u-trim\"><div class=\"su-button-center\"><a href=\"https:\/\/ijmhr.org\/ijar-vol-7-1.htm\" class=\"su-button su-button-style-default\" style=\"color:#FFFFFF;background-color:#6b0e00;border-color:#560c00;border-radius:5px;-moz-border-radius:5px;-webkit-border-radius:5px\" target=\"_self\"><span style=\"color:#FFFFFF;padding:6px 16px;font-size:13px;line-height:20px;border-color:#98574d;border-radius:5px;-moz-border-radius:5px;-webkit-border-radius:5px;text-shadow:none;-moz-text-shadow:none;-webkit-text-shadow:none\"><i class=\"sui sui-book\" style=\"font-size:13px;color:#FFFFFF\"><\/i> Table of Contents<\/span><\/a><\/div><\/div><\/div><\/div>\n<h3 style=\"text-align: justify;\"><strong>Type of Article:<\/strong>\u00a0\u00a0Original<\/h3>\n<h3 style=\"text-align: justify;\"><strong>Volume 7; Issue 1.2 (February 2019)<\/strong><\/h3>\n<h3 style=\"text-align: justify;\"><strong>Page No.:<\/strong>\u00a06144-6148<\/h3>\n<h3 style=\"text-align: justify;\"><strong>DOI:\u00a0<\/strong>https:\/\/dx.doi.org\/10.16965\/ijar.2018.424<\/h3>\n<h3 style=\"text-align: justify;\">A STUDY ON ANATOMIC VARIATIONS OF THE PANCREATIC DUCT SYSTEM<\/h3>\n<p style=\"text-align: justify;\"><strong>Manikanta Reddy V *<sup>1<\/sup>, Vallishri V <sup>2<\/sup>, Lakshmi Devi C K <sup>3<\/sup>.<\/strong><\/p>\n<p style=\"text-align: justify;\"><sup>*1<\/sup> Assistant Professor, Department of Anatomy, ACSR Government Medical College, Nellore, Andhra Pradesh, India.<\/p>\n<p style=\"text-align: justify;\"><sup>2<\/sup> Department of Pediatrics, Pondicherry Institute of Medical Sciences, Pondicherry, India.<\/p>\n<p style=\"text-align: justify;\"><sup>3<\/sup> Professor and Head, Department of Anatomy, ACSR Government Medical College, Nellore, Andhra Pradesh, India.<\/p>\n<p style=\"text-align: justify;\"><strong>Address for Correspondence: <\/strong>Dr. V. Manikanta Reddy, Assistant Professor, Department of Anatomy, ACSR Government Medical College, Nellore, Andhra Pradesh, India.\u00a0+91 9490907429; +91 7674035146 <strong>E-Mail:<\/strong> manikantareddy.v@gmail.com<\/p>\n<p style=\"text-align: justify;\"><strong>ABSTRACT:<\/strong><\/p>\n<p style=\"text-align: justify;\"><strong>Introduction:<\/strong> Pancreatic duct system shows wide range of variations\/anomalies due to complexity in its development from two different sources namely Dorsal and Ventral pancreatic buds. Knowledge on these variations holds great importance during various surgical procedures such as drainage procedure in pancreatitis, pancreatico-jejunostomy, reconstruction after pancreatectomy and management of pancreatitis. The present study aims to explore different variations of pancreatic ducts.<\/p>\n<p style=\"text-align: justify;\"><strong>Materials and Methods:<\/strong> This cross sectional observational study was conducted in 39 pancreases. Posterior approach was chosen to expose the duct system. Two parallel incisions were made on the posterior surface of the pancreas. Tissue between these two incisions was removed by piece meal dissection and exposed the duct system.<\/p>\n<p style=\"text-align: justify;\"><strong>Observation and Results:<\/strong> out of 39 duct systems, 13 (33.3%) were normal and 26 (66.7%) were variations. These variations include 8 (20.5%) cases of Obliterated Duct of Santorini and 12 (30.76%) cases of absent Duct of Santorini, 4 (10.25%) complete pancreas divisum, 1 (2.56%) incomplete Pancreas divisum and 1 (2.56%) case of multiple ducts connecting main pancreatic duct and terminal CBD which is reported for the first time.<\/p>\n<p style=\"text-align: justify;\"><strong>Conclusion:<\/strong> Present study is in accordance with findings of most of the studies. Absent duct of Santorini was found to be higher (30.76%) among all types of variations and incomplete Pancreas Divisum with lowest occurrence (2.56%). The knowledge on the prevalence and various types of variations is highly recommended for the surgeons, Physicians and Radiologists for accurate diagnosis and efficient management of various diseases related to pancreas and pancreatico biliary apparatus.<\/p>\n<p style=\"text-align: justify;\"><strong>Key words:<\/strong> Pancreatic duct, Pancreas divisum, Duct of Santorini.<\/p>\n<p style=\"text-align: justify;\"><strong>REFERENCES<\/strong><\/p>\n<ol>\n<li style=\"text-align: justify;\">Aysel Turkvatan, Ayse Erden, Mehmet AkifTurkog\u02d8lu, OzlemYener. Congenital Variants and Anomalies of the Pancreas and Pancreatic Duct: Imaging by Magnetic Resonance Cholangiopancreaticography and Multidetector Computed Tomography. Korean J Radiol. 2013;14(6):905-913.<\/li>\n<li style=\"text-align: justify;\">Lee J. Skandalakis, Gene A, Colborn, John E. Skandalakis. Surgical Anatomy of Pancreas, Josef E. Fischer. Mastery of surgery. Ed 5. Lippincott Williams &amp; Wilkins; 2007. P 1226 \u2013 1228.<\/li>\n<li style=\"text-align: justify;\">Michael L. Steer. Exocrine pancreas. Courtney M. Townsend. Sabiston Textbook of surgery. Vol 2. ed 17<sup>th<\/sup>. New Delhi : Elsevier; 2005. P 1644 \u2013 1645.<\/li>\n<li style=\"text-align: justify;\">Tehreem Fathima. Anatomical Variants of Pancreatic Duct System In Human Cadavers. J F J M C.2010; 4 (3): 75-77.<\/li>\n<li style=\"text-align: justify;\">Ishii H , Arai K, Fukushima M, Maruoka Y, Hoshino M, Nakamura A, Koike Y,Sakamoto N, Hanada H,Kusano M, Okamatsu T. Fusion variations of pancreatic ducts in patients with anomalous arrangement of pancreaticobiliary ductal system. J Hepatobiliary Pancreat Surg. 1998;5(3):327-32.<\/li>\n<li style=\"text-align: justify;\">Lehman GA. Congenital anomalies of pancreas. In : Gastroenterologic endoscopy. Sivak Jr MV, ed 2 . Philadelphia, PA, USA: WB, Sanders company, 2000: P 1084 \u2013 97.<\/li>\n<li style=\"text-align: justify;\">Narayanan govindraj, shabna.c. Variations in the duct system of pancreas: a cadaveric study. Int j anat res 2017, vol 5(3.1):4136-43.<\/li>\n<li style=\"text-align: justify;\">Kamisawa T, Tabata I, Tajima T, Tsushima K, Yoshida Y. Patiency of the human accessory pancreatic duct as determined by dye \u2013 injection endoscopic retrograde pancreaticography. Digestion 1997; 58: 78 \u2013 82.<\/li>\n<li style=\"text-align: justify;\">Kamisawa T, Yushiike M, Egawa N, Nakajima H: patiency of accessory pancreatic duct evaluated by dye \u2013 injection endoscopicretrogradepancreatography: methods and clinical implications. J Digestive endoscopy. 2004; vol 16: 272 -76.<\/li>\n<li style=\"text-align: justify;\">Uomo G , Manes G, D Anna L, Laccetti M, Di Gaeta S, Rabitti PG. Fusion and duplication variants of pancreatic duct system. Clinical and pancreatographic evaluation.Int J Pancreatol. 1995 Feb;17(1):23-8.<\/li>\n<li style=\"text-align: justify;\">Bang S,\u00a0Suh JH,\u00a0Park BK,\u00a0Park SW,\u00a0Song SY,\u00a0Chung JB. The relationship of anatomic variation of pancreatic ductal system and pancreaticobiliary diseases. Yonsei Med J.2006 Apr 30;47(2):243-8.<\/li>\n<li style=\"text-align: justify;\">Jinxing Yu, Mary Ann Turner, Ann S. Fulcher, Robert A. Halvorsen. Congenital Anomalies and Normal Variants of the Pancreaticobiliary Tract and the Pancreas in Adults: Part 2, Pancreatic Duct and Pancreas. American Journal of Roentgenology. 2006;187: 1544-1553.<\/li>\n<li style=\"text-align: justify;\">Bret PM, Reinhold C, Taourel P, Guibaud L, AtriM, Barkun AN. Pancreas divisum: evaluationwith MR cholangiopancreatography. Radiology1996; 199:99\u2013103.<\/li>\n<li style=\"text-align: justify;\">Stimec B, Bulajic M, Korneti V, Milosavljevic T, Krstic R, Ugljesic M. Ductal morphometry of ventral pancreas in pancreas divisum. Comparison between clinical and anatomical results. Ital J Gastroenterol 1996;28:76-80.<\/li>\n<li style=\"text-align: justify;\">Terumi Kamisawa, YuyangTu, Naoto Egawa, KoujiTsuruta, Aatsutake Okamoto. Clinical Implications of Incomplete Pancreas Divisum. JOP. J Pancreas (Online) 2006; 7(6):625-630.<\/li>\n<li style=\"text-align: justify;\">Kim MH,\u00a0Lee SS,\u00a0Kim CD,\u00a0Lee SK,\u00a0Kim HJ,\u00a0Park HJ,\u00a0Joo YH,\u00a0Kim DI,\u00a0Yoo KS,\u00a0Seo DW,\u00a0Min YI. Incomplete pancreas divisum: is it merely a normal anatomic variant without clinical implications?. 2001 Sep;33(9):778-85.<\/li>\n<li style=\"text-align: justify;\">Lucas N. Pina, Leonardo Abramson, Franca S. Samoilovich, Agust\u00edn Rodriguez, D\u00e9bora C. Knaus, Mar\u00eda L. Tartaglia, Dario S. Novelli, Luis A.C. Lopolito. The pancreatic ductal system biliaropancreatic union: a study of 50 cases. Eur. J. Anat. 2013;17 (4): 193-201.<\/li>\n<li style=\"text-align: justify;\">Dawson W, Langman J An anatomical-radiological study on the pancreatic duct pattern in man. Anat Rec. 1961 Jan;139:59-68.<\/li>\n<li style=\"text-align: justify;\">Mortele KJ, Rocha TC, Streeter JL, Taylor AJ. Multimodality imaging of pancreatic and biliary congenital anomalies.Radiographics. 2006;26(3):715-731.<\/li>\n<li style=\"text-align: justify;\">Adibelli ZH, Adatepe M, Imamoglu C, Esen OS, Erkan N, Yildirim M. Anatomic variations of the pancreatic duct and their relevance with the Cambridge classification system: MRCP findings of 1158 consecutive patients. RadiolOncol. 2016;50(4):370-377.<\/li>\n<\/ol>\n<p style=\"text-align: justify;\">\n\t\t\t <div class=\"promo1\" style=\"background-color:#f7f7f7; border-color: #6b0e00 #e8e6e6 #e8e6e6;\">\n             \t <span style=\"color: #800000;\"><strong>Cite this article:<\/strong><\/span> Manikanta Reddy V, Vallishri V, Lakshmi Devi C K. A STUDY ON ANATOMIC VARIATIONS OF THE PANCREATIC DUCT SYSTEM. Int J Anat Res 2019;7(1.2):6144-6148.\u00a0<strong>DOI:\u00a0<\/strong>10.16965\/ijar.2018.424\u00a0 \n             <\/div>\t\n\t\t\n","protected":false},"excerpt":{"rendered":"<p>Type of Article:\u00a0\u00a0Original Volume 7; Issue 1.2 (February 2019) Page No.:\u00a06144-6148 DOI:\u00a0https:\/\/dx.doi.org\/10.16965\/ijar.2018.424 A STUDY ON ANATOMIC VARIATIONS OF THE PANCREATIC DUCT SYSTEM Manikanta Reddy V *1, Vallishri V 2, Lakshmi Devi C K 3. *1 Assistant Professor, Department of Anatomy, ACSR Government Medical College, Nellore, Andhra Pradesh, India. 2 Department of Pediatrics, Pondicherry Institute of<br \/><a class=\"moretag\" href=\"https:\/\/www.ijmhr.org\/IntJAnatRes\/ijar-2018-424\">+ Read More<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/www.ijmhr.org\/IntJAnatRes\/wp-json\/wp\/v2\/pages\/1724"}],"collection":[{"href":"https:\/\/www.ijmhr.org\/IntJAnatRes\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.ijmhr.org\/IntJAnatRes\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.ijmhr.org\/IntJAnatRes\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ijmhr.org\/IntJAnatRes\/wp-json\/wp\/v2\/comments?post=1724"}],"version-history":[{"count":1,"href":"https:\/\/www.ijmhr.org\/IntJAnatRes\/wp-json\/wp\/v2\/pages\/1724\/revisions"}],"predecessor-version":[{"id":1725,"href":"https:\/\/www.ijmhr.org\/IntJAnatRes\/wp-json\/wp\/v2\/pages\/1724\/revisions\/1725"}],"wp:attachment":[{"href":"https:\/\/www.ijmhr.org\/IntJAnatRes\/wp-json\/wp\/v2\/media?parent=1724"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}