{"id":722,"date":"2017-07-31T03:54:16","date_gmt":"2017-07-31T03:54:16","guid":{"rendered":"http:\/\/www.ijmhr.org\/IntJAnatRes\/?page_id=722"},"modified":"2017-08-31T04:42:43","modified_gmt":"2017-08-31T04:42:43","slug":"ijar-2017-269","status":"publish","type":"page","link":"https:\/\/www.ijmhr.org\/IntJAnatRes\/ijar-2017-269","title":{"rendered":"IJAR.2017.269"},"content":{"rendered":"
<\/i> DOWNLOAD PDF<\/span><\/a><\/div><\/div><\/div>
<\/i> Table of Contents<\/span><\/a><\/div><\/div><\/div><\/div>\n

Type of Article:<\/strong>\u00a0\u00a0Original Research<\/h3>\n

Volume 5; Issue 3.1 (July 2017)<\/strong><\/h3>\n

Page No.:<\/strong>\u00a04136-4143<\/h3>\n

DOI:\u00a0<\/strong>https:\/\/dx.doi.org\/10.16965\/ijar.2017.269<\/h3>\n

VARIATIONS IN THE DUCT SYSTEM OF PANCREAS: A CADAVERIC STUDY<\/h3>\n

Narayanan Govindraj\u00a0 *1<\/sup>, Shabna.C\u00a0 2<\/sup>.<\/strong><\/p>\n

1<\/sup> Department of Anatomy, Government medical\u00a0college\u00a0Calicut, Kerala, India.<\/p>\n

*2 <\/sup>Senior Resident, Department of Anatomy, Government medical\u00a0college\u00a0Calicut, Kerala, India.<\/p>\n

Address for Correspondence:<\/strong> Dr\u00a0Shabna\u00a0C, Senior Resident, Department of Anatomy, Government medical\u00a0college\u00a0Calicut, Kerala, India. Pin 673008\u00a0 E-Mail:<\/strong> drshabnac@gmail.com<\/p>\n

ABSTRACT<\/strong><\/p>\n

Background: <\/strong>Recently there has been growing interest in the duct system of pancreas as concerns its relationship with various disease processes as well as newer investigatory and treatment modalities related to them.This study has been aimed at evaluating the anatomy of the pancreatic duct system, thus identifying the variants to improve our knowledge of it and make things easier. The\u00a0pancreas\u00a0is formed by the fusion of the ventral and dorsal anlage, and a wide spectrum of anomalies or anatomical variations may appear related to this complicated process of fusion: e.g., agenesis, aplasia of a\u00a0pancreatic\u00a0anlage, hypoplasia, annular\u00a0pancreas,\u00a0pancreas\u00a0divisum or nonfusion of the ventral and dorsal duct system, pancreaticobiliary maljunction, etc. Every endoscopist who engages in pancreatography or related diagnostic and therapeutic procedures should always be aware of all sorts of anatomical variations he or she might encounter.<\/p>\n

Materials and Methods: <\/strong>The pancreatic duct system\u00a0 of 50 adult human specimens were demonstrated by casting with acrylic resin using postmortem preparations<\/p>\n

Results: <\/strong>The normal anatomic variants of the main pancreatic duct(duct of Wirsung) and accessory pancreatic duct(duct of Santorini) have been shown.\u00a0 In 52% of specimens, the major pancreatic duct followed the usual pattern and opened into the major duodenal papilla. Accessory pancreatic ducts were present in\u00a0\u00a0 48 % of the cases. Variations in patterns of the main duct, collecting ducts, ductules have been noted. Patterns related to certain conditions of pancreas were noted. No herring bone pattern was observed. The pancreatic duct system was classified.<\/p>\n

Conclusion: <\/strong>From the present study, it is concluded that knowledge of variation of pancreatic duct system can be used treatment of various diseases like pancreatitis pancreatic necrosis, or acute pancreatic fluid collections, chronic pancreatic fistulae and during procedures like ERCP, MRCP, EUS\u2013guided pancreaticogastrostomy (EPG), transpapillary endoprostheses, Resective or decompressive pancreatic surgery etc.<\/p>\n

Key words: <\/strong>Pancreatitis, Duct System, Duct Of\u00a0 Wirsung, Duct Of Santorini, Pancreas Divisum.<\/p>\n

REFERENCES<\/strong><\/p>\n

    \n
  1. Warshaw AL, Simeone JF, Schapiro RH, Flavin-Warshaw B. Evaluation and treatment of the dominant dorsal duct syndrome (pancreas divisum redefined). Am J Surg. 1990 Jan;159(1):59-64; discussion 64-6<\/li>\n
  2. Heiss FW, Shea JA.Association of pancreatitis and variant ductal anatomy: dominant drainage of the duct of Santorini. Am J Gastroenterol. 1978 Aug;70(2):158-62.<\/li>\n
  3. Kamisawa T. Clinical significance of the minor duodenal papilla and accessory pancreatic duct. J Gastroenterol. 2004 Jul;39(7):605<\/li>\n
  4. Kozarek RAEndoscopic therapy of complete and partial pancreatic duct disruptions. Gastrointest Endosc Clin N Am. 1998 Jan;8(1):39-53<\/li>\n
  5. R\u00f6sch,H. Koch, MD, O. Schaffner, MD,L. Demling, MD. The clinical significance of the pancreas divisum. GIE,May 1976Volume 22, Issue 4, Pages\u00a0206\u2013207<\/li>\n
  6. Ahmet Mesrur Halefoglu. Magnetic resonance cholangiopancreatography: A useful tool in the evaluation of pancreatic and biliary disorders; World J Gastroenterol. 2007 May 14; 13(18): 2529\u20132534.<\/li>\n
  7. Kahaleh M, Hernandez AJ, Tokar J, Adams RB, Shami VM, Yeaton P EUS-guided pancreaticogastrostomy: analysis of its efficacy to drain inaccessible pancreatic ducts.Gastrointest Endosc. 2007 Feb;65(2):224-30. Epub 2006 Dec 4.<\/li>\n
  8. Nealon WH, Walser E. Main pancreatic ductal anatomy can direct choice of modality for treating pancreatic pseudocysts (surgery versus percutaneous drainage). Ann Surg. 2002 Jun;235(6):751-8<\/li>\n
  9. Sahni D, Jit I, Harjeet. Gross anatomy of the pancreatic ducts in north Indians . Trop Gastroenterol. 2001 Oct-Dec;22 (4):197-201<\/li>\n
  10. Kang JK,Chung JB,\u00a0Moon YM,\u00a0Choi HJ .The normal endoscopic pancreatogram in Koreans. . Korean J Intern Med.\u00a01989 Jan;4(1):74-9<\/li>\n
  11. Kochhar R,Goenka MK,\u00a0Nagi B,\u00a0Aggarwal R,\u00a0Singh K.Normal pancreatic duct morphology in a north Indian population. Trop Gastroenterol.\u00a01996 Oct-Dec;17(4):223-5.<\/li>\n
  12. Ara S,Shahriah S,\u00a0Begum S. The length of main pancreatic duct in Bangladeshi cadaver at different age groups. Mymensingh Med J.\u00a02011 Apr;20(2):298-302.<\/li>\n
  13. Varley PF,Rohrmann CA Jr,\u00a0Silvis SE,\u00a0Vennes JA .The normal endoscopic pancreatogram. \u00a01976 Feb;118(2):295-300<\/li>\n
  14. Hadidi A.Pancreatic duct diameter: sonographic measurement in normal subjects. J Clin Ultrasound.1983 Jan;11(1):17-22.<\/li>\n
  15. Karak PK,Vashisht S,\u00a0Tandon RK,\u00a0Berry MNormal endoscopic pancreatogram in an Indian referral hospital. Indian J Med Res.\u00a01991 Dec;94:426-9<\/li>\n
  16. Ladas SD,Tassios PS,\u00a0Giorgiotis K,\u00a0Rokkas T,\u00a0Theodosiou P,\u00a0Raptis SA Pancreatic duct width: its significance as a diagnostic criterion for pancreatic disease. \u00a01993 Feb;40(1):52-5.<\/li>\n
  17. Berman G.L.,Prior.T , Abramow. M, Ziegler .D, .<\/em>A study of thee pancreatic duct system in man by the use of vinyl acetate casts of postmortem preparations. Surgery, Gynaecology, and Obstetrics, 110,391-403<\/li>\n
  18. MacCarthy L.R.,Stephens H.D., Brown.L.A., Carlson.C.H. Retrograde pancreatography in autopsy specimens. Am J Roentgenol Radium Ther Nucl Med.1975 Feb;123(2):359-66.<\/li>\n
  19. Wilasrusmee C, Pongchairerks P. Pancreaticobiliary ductal anatomy in Thai people. J Hepatobiliary Pancreat Surg. 1999;6(1):79-85.<\/li>\n
  20. Dawson W,\u00a0Langman J An anatomical-radiological study on the pancreatic duct pattern in man. Anat Rec.\u00a01961 Jan;139:59-68.<\/li>\n
  21. Toda J,\u00a0Ueno E,\u00a0Takada Y,\u00a0Okawa T. Demonstration of normal bile duct and pancreatic duct with MR cholangiopancreatography. Nihon Rinsho.\u00a01998 Nov;56(11):2830-5.<\/li>\n<\/ol>\n

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    \n \t Cite this article:<\/strong><\/span> Narayanan Govindraj, Shabna. C. VARIATIONS IN THE DUCT SYSTEM OF PANCREAS: A CADAVERIC STUDY. Int J Anat Res 2017;5(3.1):4136-4143. DOI:\u00a0<\/strong>10.16965\/ijar.2017.269 \u00a0\n <\/div>\t\n\t\t\n","protected":false},"excerpt":{"rendered":"

    Type of Article:\u00a0\u00a0Original Research Volume 5; Issue 3.1 (July 2017) Page No.:\u00a04136-4143 DOI:\u00a0https:\/\/dx.doi.org\/10.16965\/ijar.2017.269 VARIATIONS IN THE DUCT SYSTEM OF PANCREAS: A CADAVERIC STUDY Narayanan Govindraj\u00a0 *1, Shabna.C\u00a0 2. 1 Department of Anatomy, Government medical\u00a0college\u00a0Calicut, Kerala, India. *2 Senior Resident, Department of Anatomy, Government medical\u00a0college\u00a0Calicut, Kerala, India. Address for Correspondence: Dr\u00a0Shabna\u00a0C, Senior Resident, Department of Anatomy,
    + 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\/722"}],"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=722"}],"version-history":[{"count":2,"href":"https:\/\/www.ijmhr.org\/IntJAnatRes\/wp-json\/wp\/v2\/pages\/722\/revisions"}],"predecessor-version":[{"id":789,"href":"https:\/\/www.ijmhr.org\/IntJAnatRes\/wp-json\/wp\/v2\/pages\/722\/revisions\/789"}],"wp:attachment":[{"href":"https:\/\/www.ijmhr.org\/IntJAnatRes\/wp-json\/wp\/v2\/media?parent=722"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}