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Branch Fusion Between the Ventral and Dorsal Pancreatic Duct
Author(s) -
HIROOKA Takashi,
KATAOKA Shinichi,
OHCHI Hiroaki,
MARUO Takanori,
TOYONAGA Takashi,
DOZAIKU Toshio,
HAMADA Takaaki,
NAKAMICHI Kouji,
UEZU Asahiro,
NAKAMOTO Takeshi,
MAKIMOTO Shinichirou,
SHINBO Masaya,
YAMAMOTO Hiroshi,
NISHIHARA Hideki,
TACHIBANA Shogo,
KUMAGAYA Akifumi,
KIKUCHI Hiroshi
Publication year - 1994
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.1994.tb00669.x
Subject(s) - pancreatic duct , medicine , pancreatitis , dorsum , fusion , duct (anatomy) , anatomy , linguistics , philosophy
: Fusion of the dorsal and ventral pancreatic ducts exhibits various forms and one of them is branching fusion. Branch fusion was divided into 3 types according to ERP findings. Fusion of the upper branches of the ventral pancreatic duct with the dorsal pancreatic ducts was designated as being type 1. Fusion of the lower branch of the dorsal pancreatic duct with the ventral pancreatic duct in roundabout way was designated as being type 2. Fusion of the lower branch of the dorsal pancreatic duct with the ventral pancreatic duct in short way was designated as being type 3. We demonstrated the presence of branch fusion involving the branch of the dorsal pancreatic duct by histopathological examination and immunohistochemical examination using pancreatic polypeptide cells as an indicator in one patient with type 1 branch fusion and one with type 3 branch fusion who underwent a pancreatoduodenectomy. ERP showed chronic pancreatitis in 3 of 4 patients with type 1, 3 of 8 patients with type 2, and 7 of 18 patients with type 3 branch fusion, of whom 1, 2, and 4, respectively had non‐alcoholic pancreatitis. The high incidence of pancreatitis suggested that branch fusion is the cause of pancreatitis. In addition, evaluation of ERP images revealed Santorini's duct originating from the ventral pancreatic duct in 5 patients with type 1 branch fusion, suggesting the presence of the ansa pancreatica proposed by Dawson. This finding may also be closely associated with the development of pancreatitis. (Dig Endosc 1994; 6 : 87–93)