胰腺导管系统的胰管造影检查。

Pancreatographic investigation of the pancreatic duct system.

作者信息

Kamisawa T, Tu Y, Egawa N, Tsuruta K, Okamoto A

机构信息

Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Bunkyo-ku, Tokyo 113-8677, Japan.

出版信息

Surg Radiol Anat. 2007 Jul;29(5):405-8. doi: 10.1007/s00276-007-0220-6. Epub 2007 Jun 6.

DOI:10.1007/s00276-007-0220-6

PMID:17551665

Abstract

BACKGROUND

Embryologically, the pancreatic duct system develops by the fusion between the dorsal and ventral pancreatic bud ducts. It has been suggested that the proximal part of the main dorsal pancreatic duct partially regresses to form the accessory pancreatic duct (APD). Aim of this study was to clarify the anatomy of the pancreatic duct system of the head of the pancreas and investigate the embryology of the normal pancreatic duct system.

METHODS

We reviewed endoscopic retrograde pancreatography of normal pancreatic heads (n = 256) and pancreas divisum (n = 36), focusing on long inferior branches arising from the APD and the main pancreatic duct (MPD). The accessory pancreatograms were divided into two patterns of course and shape, the long type (171 cases) and the short type (85 cases) according to the length of the MPD from the orifice to the junction with the APD. The long-type APD formed a straight line and joined the MPD at the neck portion of the pancreas. The short-type APD joined the MPD near its first inferior branch.

RESULTS

The shape of the long-type APD was quite similar to that of the dorsal pancreatic duct of pancreas divisum. The short-type APD was less likely to have a long inferior branch arising from the APD. The length of the APD from the orifice to the first long inferior branch was similar in the long-type APD (19.4 +/- 4.0 mm) and in the short-type APD (18.8 +/- 4.2 mm). The first long inferior branch from the long-type APD passed though the MPD near the origin of the inferior branch from the MPD, whereas the short-type APD joined the MPD near its inferior branch.

CONCLUSIONS

There are two types of APD. The long-type APD was quite similar to the shape of the dorsal pancreatic duct of pancreas divisum, and seems to represent a continuation of the main duct of the dorsal pancreatic bud. The short-type APD was less likely to have a long inferior branch, and seems to be formed by the most proximal part of the main duct of the dorsal pancreatic bud and its long inferior branch.

摘要

背景

在胚胎学上，胰腺导管系统由背侧和腹侧胰腺芽导管融合发育而成。有人提出，主背侧胰腺导管的近端部分会部分退化形成副胰管（APD）。本研究的目的是阐明胰头的胰腺导管系统的解剖结构，并研究正常胰腺导管系统的胚胎学。

方法

我们回顾了正常胰头（n = 256）和胰腺分裂症（n = 36）的内镜逆行胰胆管造影，重点关注副胰管和主胰管（MPD）发出的长下支。根据主胰管从开口到与副胰管连接处的长度，将副胰管造影分为两种走行和形态类型，即长型（171例）和短型（85例）。长型副胰管形成一条直线，并在胰腺颈部与主胰管汇合。短型副胰管在其第一个下支附近与主胰管汇合。