STEP 4Locating the main pancreatic duct A1A2

To find the pancreatic duct, the main duct in the body of pancreas is usually located eccentrically, closer to the superior border and deeper toward the posterior surface of the gland.

If large, the duct may bulge from the anterior aspect of the gland or, if smaller, palpated or balloted as a "groove" along the long axis of the gland.

To identify a small duct, we connect a 10-ml syringe to a 23-gauge butterfly needle aiming obliquely and posteriorly in the suspected direction of the duct; avoid the neck of the pancreas when searching/aspirating to minimize injury to the underlying SMV; aspiration of clear fluid is an indication the duct has been located.

Measure duct pressure by connecting the needle to the manometer; in our experience, average pancreatic ductal pressure in chronic pancreatitis patients is 33 cmH2O (range: 20-47cmH2O), in contrast to a normal ductal pressure of ~10cmH2O.

Leave the needle in the duct.

The duct of Wirsung in the neck of the pancreas is usually eccentric and slightly superior and posterior (closer to the SMV/portal vein).

anterior anterior

Was this article helpful?

0 0
How to Stay Young

How to Stay Young

For centuries, ever since the legendary Ponce de Leon went searching for the elusive Fountain of Youth, people have been looking for ways to slow down the aging process. Medical science has made great strides in keeping people alive longer by preventing and curing disease, and helping people to live healthier lives. Average life expectancy keeps increasing, and most of us can look forward to the chance to live much longer lives than our ancestors.

Get My Free Ebook


Post a comment