[Non-fusion of the ventral and dorsal pancreatic ducts]

Non-fusion of the ventral and dorsal pancreatic ducts is an anomaly of the ductal system of the pancreas; no connection between the ventral and the dorsal pancreatic ducts. The pancreas, however, keeps normal shape examined by US, CT, and laparotomy. The dorsal pancreatography through the accessory papilla is essential in diagnosis of non-fusion, because the short pancreatic duct through the main papilla is sometimes observed in chronic pancreatitis, anomalous defect of the distal pancreas, pancreatic cancer, and cyst. The 30 cases of the non-fusion were experienced in our institute which were all confirmed by dorsal pancreatography; they were nearly half of the confirmed cases in Japan. The incidence is 0.5% in about 6000 endoscopic pancreatographies during 1969-1984. The age distribution is 25-79 year-old, the average 44.7, and 19 cases are male and 11 female. The pancreatitis-like pain is frequently observed in cases with non-fusion. The 13 cases, 43%, in our series complained of pancreatic pain (called P-group), but the other 17 did not (called non-P group). The age distribution, sex, and the incidence of alcohol intake, DM, gallstone diseases, however, are not different between these two groups. The figure of the ventral pancreatic duct was not characteristic in both groups. The obvious chronic pancreatitis (chronic dorsal pancreatitis) is only two even in P-group and none in non-P group. The pancreatitis-like pain may be occurred by the reason why the functionally lesser accessory papilla which is an only out-left of the larger dorsal pancreas in non-fusion could not adapt the over-load for the pancreas, for example by alcohol. The non-fusion of the pancreatic duct system is not a direct cause of pancreatitis but might be a disposition of it.