Patency of accessory pancreatic duct and its relation with duodenal inter papillary distance

Abstract

A patent accessory pancreatic duct (APD), which acts as a safety valve, may prevent complications of endoscopic retrograde cholangiopancreatography. The interpapillary distance is probably the easiest parameter to assess the probability of APD patency. In previous studies, the patency of APD was correlated with other morphometric parameters of the accessory duct. The present study assessed the frequency of APD patency among south Indian adult cadavers of both sexes, and correlated it with the interpapillary distance. Duodeno-pancreas specimens collected from 100 cadavers with no recorded diseases of biliary pancreatic tree were studied by routine dissection method and dye injection technique. APD had a patent communication with the duodenum in 46 specimens, and was more frequent in men. The distance between the two duodenal papillae varied from 1.6-3 cm; 98% of the patent APD specimens had an interpapillary distance of ≥2 cm. We postulate that an duodenal interpapillary distance ≥2 cm suggests patency of APD.