The Hidden Architecture of Pancreatic Ducts: 3D Anatomical Reconstruction and Its Implication on Pancreatic Resection.

IF 2.5 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2026-09-20 DOI:10.1002/jhbp.70191

Sébastien Frey, Luisa Nogueira, Sébastien Gaujoux, Karim Manai, Lilian Pimont, Karl Baqué, Michel Rayar, Nicolas Bronsard, Alain Sauvanet, Patrick Baqué

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引用次数: 0

Abstract

Background/purpose: Postoperative pancreatic fistula (POPF) is a common complication after pancreatic surgery and its mechanisms remain incompletely understood. While the diameter of the main pancreatic duct is well-known to be a risk factor of POPF, the impact of branch duct's (BD) anatomy is not known.

Methods: All consecutive pancreas procured from body donations were prospectively studied between March 2024 and March 2025. After total pancreatectomy, the main pancreatic and accessory ducts, when present, were cannulated and injected with polymerizable resin. Tissue corrosion using potassium hydroxide produced detailed 3D casts. BD were analyzed according to number, order, and angulation.

Results: Thirty 3D casts were analyzed from donors. The median number of BD was 96 ± 27, including 45 ± 8 first-order BD. Pancreatic heads exhibited the highest number of BD, while the isthmus showed the fewest (p < 0.001). Mean angulation increased progressively from 74° ± 14° in the isthmus to 81° ± 12° in the tail (p = 0.351). Ductal bifurcation of the main pancreatic duct at the corporeocaudal junction was present in 17%. The cephalic and uncinate regions displayed the most complex networks and included long ascending and descending branches.

Conclusions: Pancreatic ductal network shows substantial regional variability, which may partly explain differences in POPF risk according to the transection site.

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胰管的隐藏结构：三维解剖重建及其对胰腺切除术的意义。

背景/目的：术后胰瘘（POPF）是胰腺手术后常见的并发症，其机制尚不完全清楚。众所周知，主胰管的直径是POPF的一个危险因素，而分支胰管（BD）解剖结构的影响尚不清楚。方法：前瞻性研究2024年3月至2025年3月期间所有连续从遗体捐赠中获得的胰腺。全胰切除术后，当存在主胰管和副胰管时，插管并注射可聚合树脂。组织腐蚀使用氢氧化钾产生详细的3D铸件。根据BD的数量、顺序和成角进行分析。结果：对30例供体三维铸型进行了分析。BD的中位数为96±27例，其中一级BD为45±8例。胰头的BD数量最多，峡部的BD数量最少(p)。结论：胰腺导管网络表现出明显的区域差异，这可能部分解释了因横断部位不同而导致的POPF风险差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY

自引率

10.00%

发文量

178

审稿时长

6-12 weeks

期刊介绍： The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.