Accessory Pancreatic Ducts of the Major Duodenal Papilla: Normal Structures to be Differentiated from Cancer

Abstract
A pathologic study of 100 unselected major duodenal papillae taken at autopsy was presented to determine the incidence and distribution of small pancreatic ducts in the papilla. By means of serial sections, camera lucida drawings and wax model reproductions, small pancreatic ducts were identified in 98% of the specimens examined. These ducts emptied either into the intraduodenal bile duct, the main pancreatic duct, directly on to the surface of the papilla, or, in rare instances, through the mucosa of the duodenum entirely independently of the papilla. The ducts are connected with small lobules of gland in the body of the pancreas adjacent to the papilla. The term "accessory pancreatic ducts" is suggested for these structures. These accessory pancreatic ducts may be confused in biopsies taken from the papilla with well differentiated cancer.