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Anatomic variations of the pancreatic duct and their relevance with the Cambridge classification system: MRCP findings of 1158 consecutive patients

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ABSTRACT

Background: The study was conducted to evaluate the frequencies of the anatomic variations and the gender distributions of these variations of the pancreatic duct and their relevance with the Cambridge classification system as morphological sign of chronic pancreatitis using magnetic resonance cholangiopancreatography (MRCP).

Patients and methods: We retrospectively reviewed 1312 consecutive patients who referred to our department for MRCP between January 2013 and August 2015. We excluded 154 patients from the study because of less than optimal results due to imaging limitations or a history of surgery on pancreas. Finally a total of 1158 patients were included in the study.

Results: Among the 1158 patients included in the study, 54 (4.6%) patients showed pancreas divisum, 13 patients (1.2%) were defined as ansa pancreatica. When we evaluated the course of the pancreatic duct, we found the prevalence 62.5% for descending, 30% for sigmoid, 5.5% for vertical and 2% for loop. The most commonly observed pancreatic duct configuration was Type 3 in 528 patients (45.6%) where 521 patients (45%) had Type 1 configuration.

Conclusions: Vertical course (p = 0.004) and Type 2 (p = 0.03) configuration of pancreatic duct were more frequent in females than males. There were no statistically significant differences between the gender for the other pancreatic duct variations such as pancreas divisium, ansa pancreatica and course types other than vertical course (p > 0.05 for all). Variants of pancreas divisum and normal pancreatic duct variants were not associated with morphologic findings of chronic pancreatitis by using the Cambridge classification system. The ansa pancreatica is a rare type of anatomical variation of the pancreatic duct, which might be considered as a predisposing factor to the onset of idiopathic pancreatitis.

No MeSH data available.


Related in: MedlinePlus

Variations in the configuration of the pancreas duct. Type 1: Bifid configuration with dominant duct of Wirsung, Type 2: Bifid configuration with dominant duct of Santorini without divisum, Type 3: Rudimentary non-draining duct of Santorini, Type 4: Pancreas divisum, Type 5: Ansa pancreatica.
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j_raon-2016-0041_fig_005: Variations in the configuration of the pancreas duct. Type 1: Bifid configuration with dominant duct of Wirsung, Type 2: Bifid configuration with dominant duct of Santorini without divisum, Type 3: Rudimentary non-draining duct of Santorini, Type 4: Pancreas divisum, Type 5: Ansa pancreatica.

Mentions: The ductal configuration was evaluated as Type 1–Type 5 (Figure 5). At Type 1, there was a bifid configuration with dominant duct of Wirsung, at Type 2, there was a dominant duct of Santorini Type 5, where the duct of Santorini formed an inferior loop and connected with a side branch of the duct of Wirsung in the uncinate process.5, 6, 14


Anatomic variations of the pancreatic duct and their relevance with the Cambridge classification system: MRCP findings of 1158 consecutive patients
Variations in the configuration of the pancreas duct. Type 1: Bifid configuration with dominant duct of Wirsung, Type 2: Bifid configuration with dominant duct of Santorini without divisum, Type 3: Rudimentary non-draining duct of Santorini, Type 4: Pancreas divisum, Type 5: Ansa pancreatica.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC5120578&req=5

j_raon-2016-0041_fig_005: Variations in the configuration of the pancreas duct. Type 1: Bifid configuration with dominant duct of Wirsung, Type 2: Bifid configuration with dominant duct of Santorini without divisum, Type 3: Rudimentary non-draining duct of Santorini, Type 4: Pancreas divisum, Type 5: Ansa pancreatica.
Mentions: The ductal configuration was evaluated as Type 1–Type 5 (Figure 5). At Type 1, there was a bifid configuration with dominant duct of Wirsung, at Type 2, there was a dominant duct of Santorini Type 5, where the duct of Santorini formed an inferior loop and connected with a side branch of the duct of Wirsung in the uncinate process.5, 6, 14

View Article: PubMed Central - PubMed

ABSTRACT

Background: The study was conducted to evaluate the frequencies of the anatomic variations and the gender distributions of these variations of the pancreatic duct and their relevance with the Cambridge classification system as morphological sign of chronic pancreatitis using magnetic resonance cholangiopancreatography (MRCP).

Patients and methods: We retrospectively reviewed 1312 consecutive patients who referred to our department for MRCP between January 2013 and August 2015. We excluded 154 patients from the study because of less than optimal results due to imaging limitations or a history of surgery on pancreas. Finally a total of 1158 patients were included in the study.

Results: Among the 1158 patients included in the study, 54 (4.6%) patients showed pancreas divisum, 13 patients (1.2%) were defined as ansa pancreatica. When we evaluated the course of the pancreatic duct, we found the prevalence 62.5% for descending, 30% for sigmoid, 5.5% for vertical and 2% for loop. The most commonly observed pancreatic duct configuration was Type 3 in 528 patients (45.6%) where 521 patients (45%) had Type 1 configuration.

Conclusions: Vertical course (p = 0.004) and Type 2 (p = 0.03) configuration of pancreatic duct were more frequent in females than males. There were no statistically significant differences between the gender for the other pancreatic duct variations such as pancreas divisium, ansa pancreatica and course types other than vertical course (p > 0.05 for all). Variants of pancreas divisum and normal pancreatic duct variants were not associated with morphologic findings of chronic pancreatitis by using the Cambridge classification system. The ansa pancreatica is a rare type of anatomical variation of the pancreatic duct, which might be considered as a predisposing factor to the onset of idiopathic pancreatitis.

No MeSH data available.


Related in: MedlinePlus