関: duct of Santorini、main pancreatic duct

WordNet

a continuous tube formed by a row of elongated cells lacking intervening end walls
an enclosed conduit for a fluid
a bodily passage or tube lined with epithelial cells and conveying a secretion or other substance; "the tear duct was obstructed"; "the alimentary canal"; "poison is released through a channel in the snakes fangs" (同)epithelial duct, canal, channel
of or involving the pancreas; "pancreatic cancer"

PrepTutorEJDIC

送水管;(建物・船などの)通気管;(地下ケーブルなどの)ダクト / (体液を運ぶ)導管,(植物が水・空気を運ぶ)導管
膵臓の

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/10/31 03:09:59」(JST)

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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 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 to supply pancreatic juice provided from the exocrine pancreas which aids in digestion. 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.^[1]

The duct of Wirsung is named after its discoverer, the German anatomist Johann Georg Wirsung (1589–1643).^[2]

Accessory pancreatic duct

Most people have just one pancreatic duct. However, some have an additional accessory pancreatic duct, called the Duct of Santorini. An accessory pancreatic duct can be functional or non-functional and may open separately into the second part of the duodenum ^[3]^[4] which is dorsal and usually (in 70%) drains into to the duodenum via the minor duodenal papilla. In the other 30% 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.

It is named for Giovanni Domenico Santorini.^[5]^[6]

Clinical significance

Compression, obstruction or inflammation of the pancreatic duct may lead to acute pancreatitis. The most common cause for obstruction is choledocholithiasis, or gallstones in the common bile duct. 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]

Pancreatic ductal carcinoma is a common form of pancreatic cancer.

Additional images

ERCP image showing the pancreatic duct and biliary tree.
Accessory digestive system.
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.

References

^ 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: SRA. 37 (5): 543–6. doi:10.1007/s00276-015-1474-z. PMID 25840941.
^ doctor/2941 at Who Named It?
^ Moore KL, Dalley AF. 2006. Clinically Oriented Anatomy. 5th Ed. Lippincott Williams & Wilkins. p 287.
^ 1. Mchonde GJ, Gesase AP. Termination pattern of main and accessory pancreatic ducts among Tanzanians. Anatomy Journal of Africa. 2014; 3(1):223-227.
^ synd/3087 at Who Named It?
^ G. D. Santorini. Observationes anatomicae. Venetiis, apus J. B. Recurti, 1724
^ http://www.gastro.org/user-assets/html/eDigest/2005/December/1/120105.htm
^ Moore, Keith L.; Dalley, Arthur F. (2006). Clinically Oriented Anatomy, Fifth Edition. Lippincott Williams & Wilkins. p. 287. ISBN 0-7817-3639-0.

UpToDate Contents

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1. 膵臓ステント留置術およびその合併症の概要 overview of pancreatic stenting and its complications
2. 超音波内視鏡検査：正常な膵胆管の解剖学 endoscopic ultrasound normal pancreaticobiliary anatomy
3. Pancreas divisum: Clinical manifestations and diagnosis
4. Intraductal papillary mucinous neoplasm of the pancreas (IPMN): Evaluation and management
5. 成人における外傷による十二指腸および膵臓損傷のマネージメント management of duodenal and pancreatic trauma in adults

English Journal

Comparison of the multidetector-row computed tomography findings of IgG4-related sclerosing cholangitis and extrahepatic cholangiocarcinoma.

Yata M1, Suzuki K2, Furuhashi N2, Kawakami K2, Kawai Y3, Naganawa S2.
Clinical radiology.Clin Radiol.2016 Mar;71(3):203-10. doi: 10.1016/j.crad.2015.10.024. Epub 2015 Dec 17.
AIM: To compare the multidetector-row computed tomography (MDCT) findings of IgG4-related sclerosing cholangitis (IgG4-SC) and extrahepatic cholangiocarcinoma (EH-CCA).MATERIALS AND METHODS: Two radiologists who had no knowledge of the patients' clinical information retrospectively evaluated the CT
PMID 26703117

Progenitor cell niches in the human pancreatic duct system and associated pancreatic duct glands: an anatomical and immunophenotyping study.

Carpino G1, Renzi A2, Cardinale V3, Franchitto A2, Onori P2, Overi D2, Rossi M4, Berloco PB4, Alvaro D3, Reid LM5, Gaudio E2.
Journal of anatomy.J Anat.2016 Mar;228(3):474-86. doi: 10.1111/joa.12418. Epub 2015 Nov 27.
Pancreatic duct glands (PDGs) are tubule-alveolar glands associated with the pancreatic duct system and can be considered the anatomical counterpart of peribiliary glands (PBGs) found within the biliary tree. Recently, we demonstrated that endodermal precursor niches exist fetally and postnatally an
PMID 26610370

Duodenum-preserving pancreatic resection versus pancreaticoduodenectomy for chronic pancreatitis.

Gurusamy KS1, Lusuku C, Halkias C, Davidson BR.
The Cochrane database of systematic reviews.Cochrane Database Syst Rev.2016 Feb 3;2:CD011521. [Epub ahead of print]
BACKGROUND: Surgical excision by removal of the head of the pancreas to decompress the obstructed ducts is one of the treatment options for people with symptomatic chronic pancreatitis. Surgical excision of the head of the pancreas can be performed by excision of the duodenum along with the head of
PMID 26837472

Japanese Journal

症例下部胆管癌の膵頭十二指腸切除術後に膵癌を発症し残膵全摘術を施行した1例

外科 = Surgery : 臨床雑誌 79(5), 491-494, 2017-05
NAID 40021185605

A case of multiple synchronous quadruple cancers of the stomach, sigmoid colon, rectum, and pancreas

International Journal of Surgery Case Reports 35, 4-7, 2017-04-02
NAID 120006305649

膵外分泌細胞から膵β細胞へのtransdifferentiation

内分泌・糖尿病・代謝内科 = Endocrinology, diabetology & metabolism 44(2), 148-152, 2017-02
NAID 40021114662

★リンクテーブル★

リンク元	「膵管」
拡張検索	「chronic pancreatitis showing irregular narrowing of main pancreatic duct」「intrapancreatic duct brushing cytology」
関連記事	「duct」「pancreatic」

「膵管」

Pancreatic duct
	The pancreatic duct.
Details
Precursor	Pancreatic bud
Identifiers
Latin	ductus pancreaticus
MeSH	A03.734.667
TA	A05.9.01.015
FMA	10419
	Anatomical terminology [edit on Wikidata]