A study on the human pancreaticobiliary duct system and ampulla region with their clinical considerations.

Abstract

The purpose of this study is to present the variations of the pancreatic duct system and hepatopancreatic ampulla so that an awareness of these variations may help in surgical planning and prevention of ductal injury. Forty human pancreatic specimens were used to study the duct pattern of the pancreas and the formation and mode of termination of the pancreatic ducts. Also, the patency of the main pancreatic ducts, length of the hepatopancreatic ampulla, and length of the main pancreatic duct were measured. The main pancreatic duct was patent in 37 out of 40 specimens, 2 specimens showed the embryonic type of the duct system, and one had the duct obliterated at its duodenal end. The mode of termination of the main pancreatic and common pancreatic ducts was divided into four types. Seventy-five percent specimens belonged to type I, followed by type II in 22.5% and type III in 2.5% of specimens. The length of the main pancreatic duct ranged from 11 to 21.2cm, the average being 17.3cm, and the length of the hepatopancreatic ampulla varied from 1 to 10mm (1 to 2mm-5%, 3 to 8mm-55%, and more than 8mm in 15% of specimens), and it was absent in 25%. Awareness of these anomalies may help in surgical planning and prevention of undue ductal injury.