DUODENO-PANCREAS DUCTS : STUDY BY INJECTION-DISSECTION METHOD (ABOUT 30 CASES).

Résumé

Introduction : Advances in imaging, endoscopy and histo-embryology have provided new anatomical knowledge of the pancreas, the mapping of its ducts and its segmentation. These anatomical data have important clinical applications and open up new surgical perspectives, notably limited tumour resections within the head of the pancreas with preservation of the integrity of the duodenum and the bile duct. We performed a preliminary study of the configuration of the duodeno-pancreas ducts.

Material and methods : We studied the ducts of 30 pancreases taken from 27 fresh cadavers of African melanoderma subjects and 3 cadavers of Caucasian subjects stored in cold storage, using the injection and dissection method.

Results : The accessory pancreatic duct was present in 21 of 30 cases and opened into a permeable minor duodenal papilla in 10 of 21 cases. The configuration of the accessory pancreatic duct was classic, arising from the main pancreatic duct and running transversely above it to the medial aspect of the second duodenum. The most common configuration of the hepato-pancreatic ampulla was the "Ya" type of Flati's classification, found in 43.3% of cases, while the "Yb" type accounted for 20% of cases. Drainage of the pancreatic uncus was mainly by branches of the main pancreatic duct in 29 out of 30 cases; in one case, it presented a double drainage by the main and accessory pancreatic ducts.

Conclusion: Our results, with a few variations, are similar to those found in the literature, with the exception of the results for drainage of the uncus.