A Study On Anatomic Variations Of The Pancreatic Duct System

ABSTRACT

Introduction: Pancreatic duct system shows wide range of variations/anomalies due to complexity in itsdevelopment from two different sources namely Dorsal and Ventral pancreatic buds. Knowledge on these variationsholds great importance during various surgical procedures such as drainage procedure in pancreatitis,pancreatico-jejunostomy, reconstruction after pancreatectomy and management of pancreatitis. The presentstudy aims to explore different variations of pancreatic ducts.Materials and Methods: This cross sectional observational study was conducted in 39 pancreases. Posteriorapproach was chosen to expose the duct system. Two parallel incisions were made on the posterior surface of thepancreas. Tissue between these two incisions was removed by piece meal dissection and exposed the ductsystem.Observation and Results: out of 39 duct systems, 13 (33.3%) were normal and 26 (66.7%) were variations. Thesevariations include 8 (20.5%) cases of Obliterated Duct of Santorini and 12 (30.76%) cases of absent Duct ofSantorini, 4 (10.25%) complete pancreas divisum, 1 (2.56%) incomplete Pancreas divisum and 1 (2.56%) case ofmultiple ducts connecting main pancreatic duct and terminal CBD which is reported for the first time.Conclusion: Present study is in accordance with findings of most of the studies. Absent duct of Santorini wasfound to be higher (30.76%) among all types of variations and incomplete Pancreas Divisum with lowest occurrence(2.56%). The knowledge on the prevalence and various types of variations is highly recommended for the surgeons,Physicians and Radiologists for accurate diagnosis and efficient management of various diseases related topancreas and pancreatico biliary apparatus.