The pancreatic duct or duct of Wirsung (also, the major pancreatic duct due to the existence of an accessory pancreatic duct) is a duct joining the
pancreas to the
common bile duct. This supplies it with
pancreatic juice from the
exocrine pancreas, which aids in
digestion.
Structure
The pancreatic duct joins the
common bile duct just prior to the
ampulla of Vater, after which both ducts perforate the medial side of the second portion of the
duodenum at the
major duodenal papilla. There are many anatomical variants reported, but these are quite rare.[2]
Accessory pancreatic duct
Most people have just one pancreatic duct. However, some have an additional accessory pancreatic duct, also called the Duct of Santorini. An accessory pancreatic duct can be functional or non-functional.[3][4] It may open separately into the second part of the duodenum,[3][4] which is dorsal, and usually (in 70% of people) drains into the
duodenum via the
minor duodenal papilla. In the other 30% of people, it drains into the main pancreatic duct, which drains into the duodenum via the major duodenal papilla. The main pancreatic duct and the accessory duct both eventually—either directly or indirectly—connect to the second part ('D2', the vertical segment) of the
duodenum.
Compression, obstruction or inflammation of the pancreatic duct may lead to
acute pancreatitis. The most common cause for obstruction is the presence of
gallstones in the
common bile duct, a condition called
choledocholithiasis. Obstruction can also be due to duodenal inflammation in
Crohn's disease.[7] A gallstone may get lodged in the constricted distal end of the
ampulla of Vater, where it blocks the flow of both
bile and
pancreatic juice into the duodenum. Bile backing up into the pancreatic duct may initiate pancreatitis.[8] The pancreatic duct is generally regarded as abnormally enlarged if being over 3 mm in the head and 2 mm in the body or tail on CT scan.[9] Pancreatic duct or parts of pancreatic duct can be demonstrated on ultrasound in 75 to 85% of people.[10]
The pancreatic duct is also called the duct of Wirsung.[11] This is named after its discoverer, the German
anatomistJohann Georg Wirsung (1589–1643).[12]
Interior of the descending portion of the duodenum, showing bile papilla.
Pancreas of a human embryo of five weeks.
Pancreas of a human embryo at end of sixth week.
Pancreatic duct Deep dissection.Anterior view.
Ultrasonography of a dilated pancreatic duct (in this case 9mm) due to
pancreatic cancer.
References
^Standring S, Borley NR, eds. (2008). Gray's anatomy : the anatomical basis of clinical practice. Brown JL, Moore LA (40th ed.). London: Churchill Livingstone. pp. 1163, 1177, 1185–6.
ISBN978-0-8089-2371-8.
^Goel, Shivi; Rustagi, SM; Saha, S; Mehta, V; Suri, RK; Rath, G (July 2015). "Aberrant pancreatic ductal organisation: a case report". Surgical and Radiologic Anatomy. 37 (5): 543–6.
doi:
10.1007/s00276-015-1474-z.
PMID25840941.
S2CID6917153.
^
abMoore KL, Dalley AF. 2006. Clinically Oriented Anatomy. 5th Ed. Lippincott Williams &
Wilkins. p 287.
^
ab1. Mchonde GJ, Gesase AP. Termination pattern of main and accessory pancreatic ducts among Tanzanians. Anatomy Journal of Africa. 2014; 3(1):223–227.