A Fundamental Study of Pancreatography

Abstract

In order to provide a basis for the interpretation of pancreatograms, the relation of radiological findings of the pancreatic duct system to histological findings were studied in 84 necropsy materials, including 14 cases of carcinomatous lesions in the pancreas. The results were as follows: 1. The course of the main pancreatic duct were classified into four types and that of the accessory duct into three types. By giving these types careful embryological consideration, comprehensive understanding of these complicated courses of the ductal system is relatively easy. 2. A correlation was shown between the type of the ductal course and the form of opening into duodenum, concerning the main and accessory pancreatic, and bile ducts. The form of ductal opening seemed to play an important role to the possible disturbance of pancreatic function due to the pathological changes of ampulla region. 3. The mean maximum diameter of the main duct in 21 cases with abnormal histological finding in the pancreatic parenchyma was bigger than that in 49 normal cases but the caliber of the main duct was found to increase with age and to have remarkable variation in each individual case. 4. Narrowing of the main duct in the neck of the pancreas and the constriction immediately above the Vaterian pancreatic duct appeared to exist in normal cases. 5. Sparse ramification of ductal system in the neck of the gland seemed to be in connection with aging. 6. The diameter of the branches bigger than 1mm except the chief ones, the wavy contour of the branches and the beads-like or cystic dilatation of the branches were all closely related to the hyperplastic or metaplastic changes in the ductal epithelium and the inspissated mucinous materials in the duct. 7. In carcinomatous lesions of the pancreas, general findings were the stenosis or obstruction with rigid outline of the main duct and interruption and straightening of the branches. Above the constricted part of the duct was seen the secondary dilatation of ductal systems. © 1972, The Japanese Society of Gastroenterology. All rights reserved.