Editing Pancreas (section)

== '''Ductal system''' ==

* Usually two ducts passing     through the head
* Major duct (of Wirsung)
** 70% join with CBD to open      into the major papilla, 7cm distal to pylorus, usually D2, can be D3
** If the bile duct is seen to      overlie the vertebral column on IOC, it should alert the surgeon to the      possibility of an abnormally distal major papilla
* Accessory duct (of Santorini)
** Opens into the minor      papilla, which lies about 2cm proximal to the major papilla, and more      anteriorly
** In 6-9%, can persist with no      connection with the main duct (pancreas divisum) - see separate topic
* Main duct
** Runs closer to posterior      surface than anterior
** Begins as an identifiable      structure about 2.5cm from the tip of the tail, where its diameter is      0.5mm
** Diameter increases to      1.5-3mm at 10cm from tail
** Diameter in head is 3.5mm,      which may increase somewhat with age
** Can bifurcate into two ducts      in mid-pancreas