The pancreatic duct, or duct of Wirsung (also, the major pancreatic duct due to the existence of an accessory pancreatic duct), is a duct joining the

pancreas The pancreas is an organ of the digestive system and endocrine system of vertebrates. In humans, it is located in the abdomen behind the stomach and functions as a gland. The pancreas is a mixed or heterocrine gland, i.e. it has both an en ...

to the

common bile duct The common bile duct, sometimes abbreviated as CBD, is a duct in the gastrointestinal tract of organisms that have a gallbladder. It is formed by the confluence of the common hepatic duct and cystic duct and terminates by uniting with pancrea ...

. This supplies it with

pancreatic juice Pancreatic juice is a liquid secreted by the pancreas, which contains a number of digestive enzymes, including trypsinogen, chymotrypsinogen, elastase, carboxypeptidase, pancreatic lipase, nucleases and amylase. The pancreas is located in the ...

from the

exocrine pancreas The pancreas is an organ of the digestive system and endocrine system of vertebrates. In humans, it is located in the abdomen behind the stomach and functions as a gland. The pancreas is a mixed or heterocrine gland, i.e. it has both an endocri ...

, which aids in

digestion Digestion is the breakdown of large insoluble food molecules into small water-soluble food molecules so that they can be absorbed into the watery blood plasma. In certain organisms, these smaller substances are absorbed through the small intest ...

Structure

The pancreatic duct joins the

just prior to the ampulla of Vater, after which both ducts perforate the medial side of the second portion of the duodenum at the

major duodenal papilla Major (commandant in certain jurisdictions) is a military rank of commissioned officer status, with corresponding ranks existing in many military forces throughout the world. When used unhyphenated and in conjunction with no other indicator ...

. There are many anatomical variants reported, but these are quite rare.

Accessory pancreatic duct

Most people have just one pancreatic duct. However, some have an additional accessory pancreatic duct, also called the Duct of Santorini. An accessory pancreatic duct can be functional or non-functional. It may open separately into the second part of the duodenum,Moore KL, Dalley AF. 2006. Clinically Oriented Anatomy. 5th Ed. Lippincott Williams & Wilkins. p 287.1. Mchonde GJ, Gesase AP. Termination pattern of main and accessory pancreatic ducts among Tanzanians. Anatomy Journal of Africa. 2014; 3(1):223–227. which is dorsal, and usually (in 70% of people) drains into the duodenum via the minor duodenal papilla. In the other 30% of people, it drains into the main pancreatic duct, which drains into the duodenum via the major duodenal papilla. The main pancreatic duct and the accessory duct both eventually—either directly or indirectly—connect to the second part ('D2', the vertical segment) of the duodenum. It is named for Giovanni Domenico Santorini. File:Formation_of_an_accessory_pancreatic_duct_en.svg, Formation of an accessory pancreatic duct

Clinical significance

Compression, obstruction or inflammation of the pancreatic duct may lead to

acute pancreatitis Acute pancreatitis (AP) is a sudden inflammation of the pancreas. Causes in order of frequency include: 1) a gallstone impacted in the common bile duct beyond the point where the pancreatic duct joins it; 2) heavy alcohol use; 3) systemic disea ...

. The most common cause for obstruction is the presence of

gallstone A gallstone is a stone formed within the gallbladder from precipitated bile components. The term cholelithiasis may refer to the presence of gallstones or to any disease caused by gallstones, and choledocholithiasis refers to the presence of mi ...

s in the

, a condition called

choledocholithiasis Common bile duct stone, also known as choledocholithiasis, is the presence of gallstones in the common bile duct (CBD) (thus '' choledocho-'' + ''lithiasis''). This condition can cause jaundice and liver cell damage. Treatments include choledocholi ...

. Obstruction can also be due to duodenal inflammation in Crohn's disease. A gallstone may get lodged in the constricted distal end of the ampulla of Vater, where it blocks the flow of both bile and

into the duodenum. Bile backing up into the pancreatic duct may initiate pancreatitis. The pancreatic duct is generally regarded as abnormally enlarged if being over 3 mm in the head and 2 mm in the body or tail on CT scan. Pancreatic duct or parts of pancreatic duct can be demonstrated on ultrasound in 75 to 85% of people. Pancreatic ductal carcinoma is a common form of pancreatic cancer.

History

The pancreatic duct is also called the duct of Wirsung. This is named after its discoverer, the German

anatomist Anatomy () is the branch of biology concerned with the study of the structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old science, having it ...

Johann Georg Wirsung (1589–1643).

Additional images

File:ERCP Roentgen.jpg, ERCP image showing the pancreatic duct and

biliary tree The biliary tract, (biliary tree or biliary system) refers to the liver, gallbladder and bile ducts, and how they work together to make, store and secrete bile. Bile consists of water, electrolytes, bile acids, cholesterol, phospholipids and co ...

. File:Digestive system showing bile duct.svg, Accessory digestive system. File:Gray1057.png, Interior of the descending portion of the duodenum, showing bile papilla. File:Gray1101.png, Pancreas of a human embryo of five weeks. File:Gray1102.png, Pancreas of a human embryo at end of sixth week. File:Slide52uru.JPG, Pancreatic duct Deep dissection.Anterior view. File:Ultrasonography of dilated pancreatic duct.jpg, Ultrasonography of a dilated pancreatic duct (in this case 9mm) due to pancreatic cancer.

References

{{Authority control Pancreas anatomy