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a flask that has two handles; used by Romans for wines or oils
the dilated portion of a canal or duct especially of the semicircular canals of the ear

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《所有・所属》…『の』,…のものである,…に属する・《材料・要素》…『でできた』,から成る・《部分》…『の』[『中の』] ・《数量・単位・種類を表す名詞に付いて》…の・《原因・動機》…『で』,のために(because of) ・《主格関係》…『の』,による,によって・《目的格関係》…『を』,の・《同格関係》…『という』・《関係・関連》…『についての』[『の』],の点で・《抽象名詞などと共に》…の[性質をもつ] ・《『It is』+『形』+『of』+『名』+『to』 doの形で,ofの後の名詞を意味上の主語として》・《分離》…『から』・《起原・出所》…『から』[『の』](out of) ・《『名』+『of』+『a』(『an』)+『名』の形で》…のような・《『名』+『of』+『mine』(『yours, his』など独立所有格)の形で》…の…・《時》(1)《副詞句を作って》…に《形容詞句を作って》…の・《時刻》《米》…前(to,《米》before)
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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/01/24 20:42:52」(JST)

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The ampulla of Vater, also known as the hepatopancreatic ampulla or the hepatopancreatic duct, is formed by the union of the pancreatic duct and the common bile duct. The ampulla is specifically located at the major duodenal papilla.

The ampulla of Vater is an important landmark halfway along the second part of the duodenum that marks the anatomical transition from foregut to midgut, and hence the point where the celiac trunk stops supplying the gut and the superior mesenteric artery takes over.

Structure

1. Bile ducts: 2. Intrahepatic bile ducts, 3. Left and right hepatic ducts, 4. Common hepatic duct, 5. Cystic duct, 6. Common bile duct, 7. Ampulla of Vater, 8. Major duodenal papilla
9. Gallbladder, 10–11. Right and left lobes of liver. 12. Spleen.
13. Esophagus. 14. Stomach. 15. Pancreas: 16: Accessory pancreatic duct, 17: Pancreatic duct.
18. Small intestine: 19. Duodenum, 20. Jejunum
21–22: Right and left kidneys (silhouette).

The anterior border of the liver is lifted upwards (brown arrow). Gallbladder with Longitudinal section, pancreas and duodenum with frontal one. Intrahepatic ducts and stomach in transparency.

The cystic duct leaves the gallbladder and joins with the common hepatic duct to form the common bile duct. This duct subsequently joins with the pancreatic duct; this junction is known as the ampulla of Vater. The pancreatic duct delivers substances such as bicarbonate and digestive enzymes to the duodenum. The bile from the gallbladder contains salts which emulsify large fat droplets into much smaller units. This provides a large surface area for the lipase enzymes to act on. The bicarbonate neutralises the acidic chyme, creating alkaline conditions for enzymes such as chymotrypsin and amylase to function optimally.

Function

Various smooth muscle sphincters regulate the flow of bile and pancreatic juice through the ampulla: the sphincter of the pancreatic duct, the sphincter of the bile duct, and the sphincter of Oddi.^{[citation needed]}

The sphincter of Oddi controls the introduction of bile and pancreatic secretions into the duodenum, as well as preventing the entry of duodenal contents into the ampulla.

Clinical relevance

Pancreatitis can result from a failure of pancreatic secretions to drain properly. One possible cause of impaired drainage of pancreatic juice is blockage of the sphincter of Oddi. A common cause of blockage is a gallstone in the common bile duct.

History

The eponymic term "ampulla of Vater" is named after Abraham Vater (1684–1751),^[1] a German anatomist who first published a description of it in 1720.^[2]

Additional images

The pancreatic duct.
Carcinoma of Ampulla

References

^ Lerch MM, Domschke W (2000) Abraham Vater of the ampulla (papilla) of Vater. Gastroenterology 118 (2):379. PMID 10691372
^ synd/3095 at Who Named It?

"Ampulla, hepatopancreatic." Stedman's Medical Dictionary, 27th ed. (2000). ISBN 0-683-40007-X
Moore, Keith L. and Arthur F. Dalley. Clinically Oriented Anatomy, 4th ed. (1999). ISBN 0-683-06141-0

UpToDate Contents

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1. 十二指腸乳頭部癌：疫学、臨床症状、診断および病期分類 ampullary carcinoma epidemiology clinical manifestations diagnosis and staging
2. 乳頭部癌：治療および予後 ampullary carcinoma treatment and prognosis
3. オッディ括約筋機能不全の臨床症状よび診断 clinical manifestations and diagnosis of sphincter of oddi dysfunction
4. 乳頭部腺腫：臨床症状および診断 ampullary adenomas clinical manifestations and diagnosis
5. 非転移性の高分化型消化管神経内分泌（カルチノイド）腫瘍の病期分類、治療、治療後サーベイランス staging treatment and posttreatment surveillance of nonmetastatic well differentiated gastrointestinal tract neuroendocrine carcinoid tumors

English Journal

Undifferentiated carcinoma of the ampulla of Vater.

Yamada M1, Furukawa D2, Yazawa N1, Izumi H1, Masuoka Y1, Mashiko T1, Kawaguchi Y3, Ogawa M3, Kawashima Y3, Mine T3, Hirabayashi K4, Nakagohri T1.
Surgical case reports.Surg Case Rep.2017 Dec;3(1):9. doi: 10.1186/s40792-016-0284-9. Epub 2017 Jan 6.
PMID 28063144

Suggestion of added value by bevacizumab to chemotherapy in patients with unresectable or recurrent small bowel cancer.

Takayoshi K1,2, Kusaba H1, Uenomachi M3, Mitsugi K3, Makiyama C4, Makiyama A4, Uchino K5, Shirakawa T6, Shibata Y7, Shinohara Y2, Inadomi K1, Tsuchihashi K1, Arita S8, Ariyama H1, Esaki T2, Akashi K1, Baba E9.
Cancer chemotherapy and pharmacology.Cancer Chemother Pharmacol.2017 Aug;80(2):333-342. doi: 10.1007/s00280-017-3371-0. Epub 2017 Jun 26.
PMID 28653251

Systematic evaluation of radiological findings in the assessment of resectability of peri-ampullary cancer by CT using different contrast phase protocols.

Amr B1, Miles G2, Shahtahmassebi G3, Roobottom C4, Stell DA1.
Clinical radiology.Clin Radiol.2017 Aug;72(8):691.e11-691.e17. doi: 10.1016/j.crad.2017.02.012. Epub 2017 Mar 11.
PMID 28292513

Japanese Journal

Metachronous Bilateral Pulmonary Metastases from Cancer of the Ampulla Duodeni

Kuwahara Motohisa,Ishii Hidenobu,Naritomi Kazuya,Mano Masae,Yanagisawa Jun,Shirakusa Takayuki,Iwasaki Akinori
Annals of
… We present a 76-year-old man who underwent two lung resections for metastases originating from cancer of the Ampulla duodeni, 9 years-after pancreaticoduodenectomy with lymphadenectomy. … histological examination of the original tumor revealed a stage III tubular adenocarcinoma (pT3, N0, M0). … Repetitive lung resection was performed in 2007 (left S8) and 2011 (right S1 and extirpation of a pericardial cyst). …
NAID 130003377867

A Case of Cancer of the Ampulla of Vater Accompanied by Malrotation

KAWAHARA RYUICHI,HORIUCHI HIROYUKI,NOGITA HIDEFUMI,AKASHI MASANORI,MIKAGI KAZUHIRO,YOSHITOMI MUNEHIRO,AKASU GEN,KITASATO YUHEI,KAWASHIMA YUSUKE,ISHIKAWA HIROTO,HISAKA TOHRU,KINOSHITA HISAFUMI,TANAKA HIROYUKI
The Kurume Medical Journal 60(1), 33-36, 2013
… Intestinal malrotation is caused by a developmental anomaly of the embryonic intestine. … <BR>Pancreaticoduodenectomy was performed for cancer of the ampulla of Vater accompanied by incomplete fixation in a 63-year-old male patient. …
NAID 130003368266

Related Pictures

★リンクテーブル★

リンク元	「ファーター膨大部」

「ファーター膨大部」

Ampulla of Vater
	A diagram of the biliary system. Note that the ampulla of Vater is behind the major duodenal papilla.
	The major duodenal papilla, seen on duodenoscopy at the time of ERCP. This is the protrusion of the ampulla of Vater into the duodenum.
Details
Identifiers
Latin	Ampulla hepatopancreatica, ampulla Vaterii
MeSH	A03.159.183.079.300.950
TA	A05.8.02.017
FMA	15076
	Anatomical terminology [edit on Wikidata]

　　[★]

英: Vater ampulla, ampulla of Vater
同: 胆膵管膨大部、ファーテル膨大部

[pmid10691372-1] Lerch MM, Domschke W (2000) Abraham Vater of the ampulla (papilla) of Vater. Gastroenterology 118 (2):379. PMID 10691372

[2] synd/3095 at Who Named It?

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案内

ampulla of Vater