title: Does a patent accessory pancreatic duct prevent acute pancreatitis?
abstract: OBJECTIVE
  The role of the accessory pancreatic duct (APD) in pancreatic pathophysiology has been unclear. We previously examined the patency of the APD in 291 control cases who had a normal pancreatogram in the head of the pancreas by dye-injection endoscopic retrograde pancreatography (ERP). APD patency was 43% and was closely related with the shape of the terminal portion of the APD. The present study aimed to clarify the clinical implications of a patent APD.
  
  
  METHODS
  Based on the underlying data, the patency rate of the APD was estimated from the terminal shape of the APD on ERP in 167 patients with acute pancreatitis.
  
  
  RESULTS
  In patients with acute pancreatitis, stick-type APD, spindle-type APD, and cudgel-type APD, which showed a high patency, were rare, and branch-type APD and halfway-type or no APD, which showed quite low patency, were frequent in acute pancreatitis patients. Accordingly, the estimated patency of the APD in acute pancreatitis patients was only 21%. There was no significant relationship between the estimated APD patency and etiology or severity of acute pancreatitis.
  
  
  CONCLUSIONS
  The terminal shapes of the APD with low patency were frequent in acute pancreatitis patients, and estimated APD patency was only 21% in acute pancreatitis. A patent APD may function as a second drainage system to reduce the pressure in the main pancreatic duct and prevent acute pancreatitis.
authors.affiliation: Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan.
authors.forename: Taku
authors.initials: T
authors.lastname: Tabata
authors.forename: Terumi
authors.initials: T
authors.lastname: Kamisawa
authors.forename: Kensuke
authors.initials: K
authors.lastname: Takuma
authors.forename: Hajime
authors.initials: H
authors.lastname: Anjiki
authors.forename: Junko
authors.initials: J
authors.lastname: Fujiwara
authors.forename: Hideto
authors.initials: H
authors.lastname: Egashira
authors.forename: Koichi
authors.initials: K
authors.lastname: Koizumi
authors.forename: Naoto
authors.initials: N
authors.lastname: Egawa
mesh_terms: D000208:Acute Disease; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D006801:Humans; D008297:Male; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging / Q000503:physiopathology*; D010195:Pancreatitis / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D012307:Risk Factors