Exploring the variations of the pancreatic ductal system: a systematic review and metaanalysis of observational studies

• 영문명: Exploring the variations of the pancreatic ductal system: a systematic review and metaanalysis of observational studies
• 발행기관: 대한해부학회
• 저자명: Adil Asghar Ravi Kant Narayan Nagavalli Basavanna Pushpa Apurba Patra Kumar Satish Ravi R. Shane Tubbs
• 간행물 정보: 『Anatomy and Cell Biology』Vol.57(1), 31~44쪽, 전체 14쪽
• 주제분류: 의약학 > 의학일반
• 파일형태: PDF
• 발행일자: 2024.03.30

영문 초록

The exocrine part of the pancreas has a duct system called the pancreatic ductal system (PDS). Its mechanism of development is complex, and any reorganization during early embryogenesis can give rise to anatomical variants. The aim of this study is to collect, classify, and analyze published evidence on the importance of anatomical variants of the PDS, addressing gaps in our understanding of such variations. The MEDLINE, Web of Science, Embase, and Google Scholar databases were searched to identify publications relevant to this review. R studio with meta-package was used for data extraction, risk of bias estimation, and statistical analysis. A total of 64 studies out of 1,778 proved suitable for this review and metanalysis. The meta-analysis computed the prevalence of normal variants of the PDS (92% of 10,514 subjects). Type 3 variants and “descending” subtypes of the main pancreatic duct (MPD) predominated in the pooled samples. The mean lengths of the MPD and accessory pancreatic duct (APD) were 16.53 cm and 3.36 cm, respectively. The mean diameters of the MPD at the head and the APD were 3.43 mm and 1.69 mm, respectively. The APD was present in only 41% of samples, and the long type predominated. The pancreatic ductal anatomy is highly variable, and the incorrect identification of variants may be challenging for surgeons during ductal anastomosis with gut, failure to which may often cause ductal obstruction or pseudocysts formation.

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ORCID

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Conflicts of Interest

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키워드

Cholangiopancreatography Accessory pancreatic duct Endoscopic retrograde cholangiopancreatography Magnetic resonance cholangiopancreatography Pancreatitis