Skip to main content
Top
Published in: Surgical and Radiologic Anatomy 8/2010

01-10-2010 | Original Article

New anatomical data on the drainage patterns of the uncinate process of the pancreas

Authors: Françoise Schmitt, Aurélie Maignan, Stéphane Ploteau, Antoine Hamel, Stéphane Lagier, Yvan Blin, Jean-Michel Rogez, Joël Le Borgne

Published in: Surgical and Radiologic Anatomy | Issue 8/2010

Login to get access

Abstract

Purpose

Recently, progress has been made in the surgical management of benign pancreatic tumors sparing as much of the pancreatic parenchyma and pancreatic function as possible. However, the main complication of partial pancreatectomy is the disruption of pancreatic ducts ensuing leak of pancreatic secretion leading to the formation of pancreatic fistulae. In this study, we attempt to precisely define the anatomy of the branch duct draining the uncinate process which is of interest to the surgeons.

Methods

Seventeen formalin-fixed pancreases were taken and ducts were injected with a colored gelatin solution. Within the uncinate process of the pancreases, the branch duct was localized, measured and its anatomical drainage defined. Statistics were performed using Spearman’s correlation test.

Results

The uncinate process was drained exclusively by the main pancreatic duct in ten cases, by the accessory pancreatic duct in three cases, and by both the ducts in four cases. All of the branches drained into the main pancreatic duct downstream to the junction between the main and the accessory pancreatic duct, except for one.

Conclusions

We have precised the possibility of double drainage of the uncinate process, but this could not be correlated with simple anatomical or radiological landmarks such as the length of the main pancreatic duct or the patency of the minor duodenal papilla.
Literature
1.
go back to reference Bassi C, Crippa S, Salvia R (2008) Intraductal papillary mucinous neoplasms (IPMNs): is it time to spare the knife? Gut 57:287–289CrossRefPubMed Bassi C, Crippa S, Salvia R (2008) Intraductal papillary mucinous neoplasms (IPMNs): is it time to spare the knife? Gut 57:287–289CrossRefPubMed
2.
go back to reference Blanc B, Sauvanet A, Couvelard A, Pessaux P, Dokmak S, Vullierme M-P, Lévy P, Rusniewski P, Belghiti J (2008) Résections limitées du pancréas pour tumeur intracanalaire papillaire et mucineuse non invasive. J Chir 145:568–578CrossRef Blanc B, Sauvanet A, Couvelard A, Pessaux P, Dokmak S, Vullierme M-P, Lévy P, Rusniewski P, Belghiti J (2008) Résections limitées du pancréas pour tumeur intracanalaire papillaire et mucineuse non invasive. J Chir 145:568–578CrossRef
3.
go back to reference Delmas A (1939) Les ébauches pancréatiques dorsales et ventrales. Leurs rapports dans la constitution du pancréas définitif. Annals Anat Path 16:253–266 Delmas A (1939) Les ébauches pancréatiques dorsales et ventrales. Leurs rapports dans la constitution du pancréas définitif. Annals Anat Path 16:253–266
4.
go back to reference Kanazumi N, Kaneko T, Takeda S, Harada A, Inoue S, Nagasaka T, Nakashima N (2001) Surgical treatment of intraductal papillary-mucinous tumors of the pancreas. Hepatogastroenterology 48:967–971PubMed Kanazumi N, Kaneko T, Takeda S, Harada A, Inoue S, Nagasaka T, Nakashima N (2001) Surgical treatment of intraductal papillary-mucinous tumors of the pancreas. Hepatogastroenterology 48:967–971PubMed
5.
go back to reference Kloepple G, Solcia E, Longnecker DS, Capella C, Sobin LH (1996) Histological typing of tumours of the exocrine pancreas; in World Health Organization: international histological classification of tumours, 2nd edn. Springer Verlag, Berlin Kloepple G, Solcia E, Longnecker DS, Capella C, Sobin LH (1996) Histological typing of tumours of the exocrine pancreas; in World Health Organization: international histological classification of tumours, 2nd edn. Springer Verlag, Berlin
6.
go back to reference Ohashi K, Murakami Y, Murayama M et al (1982) Four cases of mucus secreting pancreatic cancer. Prog Dig Endosc 20:348–351 Ohashi K, Murakami Y, Murayama M et al (1982) Four cases of mucus secreting pancreatic cancer. Prog Dig Endosc 20:348–351
7.
go back to reference Rivera JA, Castillo CF, Pins M, Compton CC, Lewandrowski KB, Rattner DW, Warshaw AL (1997) Pancreatic mucinous ductal ectasia and intraductal papillary neoplasms: a single malignant clinicopathologic entity. Ann Surg 225(6):637–646CrossRefPubMed Rivera JA, Castillo CF, Pins M, Compton CC, Lewandrowski KB, Rattner DW, Warshaw AL (1997) Pancreatic mucinous ductal ectasia and intraductal papillary neoplasms: a single malignant clinicopathologic entity. Ann Surg 225(6):637–646CrossRefPubMed
8.
go back to reference Russu IG, Vaida A (1959) Neue Befunde zur Entwicklung der Bauchspeicheldrüse. Acta Anat 15:68–84 Russu IG, Vaida A (1959) Neue Befunde zur Entwicklung der Bauchspeicheldrüse. Acta Anat 15:68–84
9.
go back to reference Salvia R, Partelli S, Crippa S, Landoni L, Capelli P, Manfredi R, Bassi C, Pederzoli P (2009) Intraductal papillary mucinous neoplasms of the pancreas with multifocal involvement of branch ducts. Am J Surg 198:709–714CrossRefPubMed Salvia R, Partelli S, Crippa S, Landoni L, Capelli P, Manfredi R, Bassi C, Pederzoli P (2009) Intraductal papillary mucinous neoplasms of the pancreas with multifocal involvement of branch ducts. Am J Surg 198:709–714CrossRefPubMed
10.
go back to reference Sata N, Kurihara K, Koizumi M, Tsukahara M, Yoshizawa K, Nagai H (2006) CT virtual pancreatoscopy: a new method for diagnosing intraductal papillary mucinous neoplasm (IPMN) of the pancreas. Abdom Imaging 31:326–331CrossRefPubMed Sata N, Kurihara K, Koizumi M, Tsukahara M, Yoshizawa K, Nagai H (2006) CT virtual pancreatoscopy: a new method for diagnosing intraductal papillary mucinous neoplasm (IPMN) of the pancreas. Abdom Imaging 31:326–331CrossRefPubMed
11.
go back to reference Sharma MS, Brams DM, Birkett DH, Munson JL (2006) Uncinatectomy: a novel surgical option for the management of intraductal papillary mucinous tumors of the pancreas. Dig Surg 23:121–124CrossRefPubMed Sharma MS, Brams DM, Birkett DH, Munson JL (2006) Uncinatectomy: a novel surgical option for the management of intraductal papillary mucinous tumors of the pancreas. Dig Surg 23:121–124CrossRefPubMed
12.
go back to reference Shyr YM, Su CH, Tsay SH, Lui WY (1996) Mucin-producing neoplasms of the pancreas: intraductal papillary and mucinous cystic neoplasms. Ann Surg 223(2):141–146CrossRefPubMed Shyr YM, Su CH, Tsay SH, Lui WY (1996) Mucin-producing neoplasms of the pancreas: intraductal papillary and mucinous cystic neoplasms. Ann Surg 223(2):141–146CrossRefPubMed
13.
go back to reference Takahashi S, Akita K, Goseki N, Sato T (1999) Spatial arrangement of the pancreatic ducts in the head of the pancreas with special reference to the branches of the uncinate process. Surgery 125:178–185PubMed Takahashi S, Akita K, Goseki N, Sato T (1999) Spatial arrangement of the pancreatic ducts in the head of the pancreas with special reference to the branches of the uncinate process. Surgery 125:178–185PubMed
14.
go back to reference Uchida T, Takada T, Ammori BJ, Suda K, Takahashi T (1999) Three-dimensional reconstruction of the ventral and dorsal pancreas: a new insight into the anatomy and embryonic development. J Hepatobiliary Pancreat Surg 6:176–180CrossRefPubMed Uchida T, Takada T, Ammori BJ, Suda K, Takahashi T (1999) Three-dimensional reconstruction of the ventral and dorsal pancreas: a new insight into the anatomy and embryonic development. J Hepatobiliary Pancreat Surg 6:176–180CrossRefPubMed
15.
go back to reference Zamora C, Sahel J, Cantu DG, Heyries L, Bernard JP, Bastid C, Payan MJ, Sielezneff I, Familiari L, Sastre B, Barthet M (2001) Intraductal papillary or mucinous tumors (IPMT) of the pancreas: report of a case series and review of the literature. Am J Gastroenterol 96:1441–1447CrossRefPubMed Zamora C, Sahel J, Cantu DG, Heyries L, Bernard JP, Bastid C, Payan MJ, Sielezneff I, Familiari L, Sastre B, Barthet M (2001) Intraductal papillary or mucinous tumors (IPMT) of the pancreas: report of a case series and review of the literature. Am J Gastroenterol 96:1441–1447CrossRefPubMed
Metadata
Title
New anatomical data on the drainage patterns of the uncinate process of the pancreas
Authors
Françoise Schmitt
Aurélie Maignan
Stéphane Ploteau
Antoine Hamel
Stéphane Lagier
Yvan Blin
Jean-Michel Rogez
Joël Le Borgne
Publication date
01-10-2010
Publisher
Springer-Verlag
Published in
Surgical and Radiologic Anatomy / Issue 8/2010
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-010-0680-y

Other articles of this Issue 8/2010

Surgical and Radiologic Anatomy 8/2010 Go to the issue