Endoscopic retrograde pancreatography: analysis of the normal pancreatogram

Thirty-five pancreatograms were selected from 62 which were obtained during endoscopic cannulation of the papilla of Vater with retrograde injection of radiopaque medium. Pancreatograms were selected on the basis of the quality of the study and on the absence of any clinically demonstrable pancreatic disease. Measurements were made of the main pancreatic duct (MPD) in the head, body, and tail, as well as the length of the duct. Although there is a wide range of normal, practical reference figures for the diameters of the main duct in the head, body, and tail are 3, 2 and 1 mm, respectively. The length averages 15.4 cm. No correlation was found between the measurements and the body surface area, age, or sex of the patient. Comparisons are made with other autopsy and endoscopic studies, and attention is focused on the salient anatomic features, including normal points of narrowing of the duct, the accessory pancreatic duct (APD), and the main pancreatic duct branches (MPDB).