New Classification for the Accessory Pancreatic Duct by ERP

Area of Science:

• Gastroenterology
• Anatomy
• Embryology

Background:

• The pancreatic duct system, particularly in the pancreatic head, is complex.
• Embryological development involves two anlage contributing to the pancreas.

Purpose of the Study:

• To devise a novel classification for the accessory pancreatic duct (APD).
• To correlate APD morphology with its junctional point to the main pancreatic duct (MPD).
• To assess the applicability of the new classification in understanding pancreatic duct embryogenesis.

Main Methods:

• Review of 385 random endoscopic retrograde pancreatograms of normal pancreatic heads.
• Analysis of accessory pancreatic duct (APD) and main pancreatic duct (MPD) imaging.
• Classification based on APD junctional point with MPD and APD shape.

Main Results:

• A four-type classification system for the APD was established.
• Types include long, intermediate, short, and ansa, defined by MPD length to junction and APD shape.
• The long type APD may represent a persistent main drainage duct of the dorsal pancreatic primordium.

Conclusions:

• The novel APD classification is applicable to most cases.
• This classification may offer insights into the embryological development of the accessory pancreatic duct.
• It provides a standardized approach to describing APD anatomy.