Abstract
Background: Pancreatic juice flows into the duodenum via two pancreatic ducts including Wirsung's duct (main pancreatic duct) and Santorini's duct (accessory pancreatic duct). In contrast to Wirsung's duct, the precise anatomy and functions of Santorini's duct are still obscure.Methods: We clinically examined the shape and the patency of Santorini's duct using a balloon endoscopic retrograde pancreatography compression study (balloon ERP‐CS) and analyzed 178 cases out of a total of 683 of balloon ERP‐CS cases according to our criteria.Results: We found the total patency ratio of Santorini's duct to be 78.1% (139 of 178 cases). The shape of Santorini's duct, as examined by balloon ERP‐CS, was classified into four types. The most common types were the Rod type (44%) and the Spindle type (25%). The Branch type comprised 22%. The most rare type was the Cystic type (9%). The Rod type and Spindle type showed a high patency ratio (more than 95%), but the Cystic type and Branch type showed lower levels (36 and 31%, respectively).Conclusions: Most cases with a poor flow of Santorini's duct were observed, especially in the Cystic and Branch types. In such cases, Santorini's duct could not function as a safety valve when a Wirsung's obstruction occurred in association with stones, tumors or edema in the papilla of Vater.
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