1992 Volume 34 Issue 11 Pages 2623-2630
We reported two cases of branch fusion type between ventral and dorsal pancreatic ducts. The diagnosis was confirmed by endoscopic retrograde pancreatography (ERP) and pathological examinations. Case 1: A 48-year old man without drinking history had suffered from recurrent pancreatitis. ERP showed the malfusion of the pancreatic duct (branch fusion type 1) and pancreatic duct stone impacted at fusion site. Case 2: A 67-year-old man presenting abdominal fullness was diagnosed as cholangiocarcinoma with ultrasonic sonography and percutaneous transhepatic cholangioscopy. ERP revealed the malfusion of the pancreatic ducts (branch fusion type 3) and pancreatic stone in dorsal duct. Pancreatoduodenoectomy was carried out on these two patiets. Branch fusion was proved by macroscopicaly and microscopicaly. Furthermore, immunohistochemical studies stained with anti-pancreatic polypeptide antibody showed that the duct connecting ventral and dorsal pancreatic ducts was identified as a branch of the dorsal duct. Pathological changes were more severe in ventral pancreas than that in dorsal one. Pancreatitis may occur more often in ventral pancreas than that in dorsal one on the patient with a branch fusion of the pancreatic duct. Apparently, branch fusion of the pancreatic duct suggested to be acausative factor of pancreatitis in our two cases.
