Meandering main pancreatic duct as a relevant factor to the onset of idiopathic recurrent acute pancreatitis.

<h4>Background</h4>Meandering main pancreatic duct (MMPD), which comprises loop type and reverse-Z type main pancreatic duct (MPD), has long been discussed its relation to pancreatitis. However, no previous study has investigated its clinical significance. We aimed to determine the non-b...

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Autores principales:	Wataru Gonoi, Hiroyuki Akai, Kazuchika Hagiwara, Masaaki Akahane, Naoto Hayashi, Eriko Maeda, Takeharu Yoshikawa, Shigeru Kiryu, Minoru Tada, Kansei Uno, Hiroshi Ohtsu, Naoki Okura, Kazuhiko Koike, Kuni Ohtomo
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8f0814994f074ccea833b5770bf1e703
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spelling	oai:doaj.org-article:8f0814994f074ccea833b5770bf1e7032021-11-18T07:17:32ZMeandering main pancreatic duct as a relevant factor to the onset of idiopathic recurrent acute pancreatitis.1932-620310.1371/journal.pone.0037652https://doaj.org/article/8f0814994f074ccea833b5770bf1e7032012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22655061/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Meandering main pancreatic duct (MMPD), which comprises loop type and reverse-Z type main pancreatic duct (MPD), has long been discussed its relation to pancreatitis. However, no previous study has investigated its clinical significance. We aimed to determine the non-biased prevalence and the effect of MMPD on idiopathic pancreatitis using non-invasive magnetic resonance (MR) technique.<h4>Methods and findings</h4>A cross-sectional study performed in a tertiary referral center. The study enrolled 504 subjects from the community and 30 patients with idiopathic pancreatitis (7 acute, 13 chronic, and 10 recurrent acute). All subjects underwent MR scanning and medical examination. MMPD was diagnosed when the MPD in the head of pancreas formed two or more extrema in the horizontal direction on coronal images of MR cholangiopancreatography, making a loop or a reverse-Z shaped hairpin curves and not accompanied by other pancreatic ductal anomaly. Statistical comparison was made among groups on the rate of MMPD including loop and reverse-Z subtypes, MR findings, and clinical features. The rate of MMPD was significantly higher for all idiopathic pancreatitis/idiopathic recurrent acute pancreatitis (RAP) (20%/40%; P<0.001/0.0001; odds ratio (OR), 11.1/29.0) than in the community (2.2%) but was not higher for acute/chronic pancreatitis (14%/8%; P = 0.154/0.266). Multiple logistic regression analysis revealed MMPD to be a significant factor that induces pancreatitis/RAP (P<0.0001/0.0001; OR, 4.01/26.2). Loop/reverse-Z subtypes were found more frequently in idiopathic RAP subgroup (20%/20%; P = 0.009/0.007; OR, 20.2/24.2) than in the community (1.2%/1.0%). The other clinical and radiographic features were shown not associated with the onset of pancreatitis.<h4>Conclusions</h4>MMPD is a common anatomical variant and might be a relevant factor to the onset of idiopathic RAP.Wataru GonoiHiroyuki AkaiKazuchika HagiwaraMasaaki AkahaneNaoto HayashiEriko MaedaTakeharu YoshikawaShigeru KiryuMinoru TadaKansei UnoHiroshi OhtsuNaoki OkuraKazuhiko KoikeKuni OhtomoPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 5, p e37652 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Wataru Gonoi Hiroyuki Akai Kazuchika Hagiwara Masaaki Akahane Naoto Hayashi Eriko Maeda Takeharu Yoshikawa Shigeru Kiryu Minoru Tada Kansei Uno Hiroshi Ohtsu Naoki Okura Kazuhiko Koike Kuni Ohtomo Meandering main pancreatic duct as a relevant factor to the onset of idiopathic recurrent acute pancreatitis.
description	<h4>Background</h4>Meandering main pancreatic duct (MMPD), which comprises loop type and reverse-Z type main pancreatic duct (MPD), has long been discussed its relation to pancreatitis. However, no previous study has investigated its clinical significance. We aimed to determine the non-biased prevalence and the effect of MMPD on idiopathic pancreatitis using non-invasive magnetic resonance (MR) technique.<h4>Methods and findings</h4>A cross-sectional study performed in a tertiary referral center. The study enrolled 504 subjects from the community and 30 patients with idiopathic pancreatitis (7 acute, 13 chronic, and 10 recurrent acute). All subjects underwent MR scanning and medical examination. MMPD was diagnosed when the MPD in the head of pancreas formed two or more extrema in the horizontal direction on coronal images of MR cholangiopancreatography, making a loop or a reverse-Z shaped hairpin curves and not accompanied by other pancreatic ductal anomaly. Statistical comparison was made among groups on the rate of MMPD including loop and reverse-Z subtypes, MR findings, and clinical features. The rate of MMPD was significantly higher for all idiopathic pancreatitis/idiopathic recurrent acute pancreatitis (RAP) (20%/40%; P<0.001/0.0001; odds ratio (OR), 11.1/29.0) than in the community (2.2%) but was not higher for acute/chronic pancreatitis (14%/8%; P = 0.154/0.266). Multiple logistic regression analysis revealed MMPD to be a significant factor that induces pancreatitis/RAP (P<0.0001/0.0001; OR, 4.01/26.2). Loop/reverse-Z subtypes were found more frequently in idiopathic RAP subgroup (20%/20%; P = 0.009/0.007; OR, 20.2/24.2) than in the community (1.2%/1.0%). The other clinical and radiographic features were shown not associated with the onset of pancreatitis.<h4>Conclusions</h4>MMPD is a common anatomical variant and might be a relevant factor to the onset of idiopathic RAP.
format	article
author	Wataru Gonoi Hiroyuki Akai Kazuchika Hagiwara Masaaki Akahane Naoto Hayashi Eriko Maeda Takeharu Yoshikawa Shigeru Kiryu Minoru Tada Kansei Uno Hiroshi Ohtsu Naoki Okura Kazuhiko Koike Kuni Ohtomo
author_facet	Wataru Gonoi Hiroyuki Akai Kazuchika Hagiwara Masaaki Akahane Naoto Hayashi Eriko Maeda Takeharu Yoshikawa Shigeru Kiryu Minoru Tada Kansei Uno Hiroshi Ohtsu Naoki Okura Kazuhiko Koike Kuni Ohtomo
author_sort	Wataru Gonoi
title	Meandering main pancreatic duct as a relevant factor to the onset of idiopathic recurrent acute pancreatitis.
title_short	Meandering main pancreatic duct as a relevant factor to the onset of idiopathic recurrent acute pancreatitis.
title_full	Meandering main pancreatic duct as a relevant factor to the onset of idiopathic recurrent acute pancreatitis.
title_fullStr	Meandering main pancreatic duct as a relevant factor to the onset of idiopathic recurrent acute pancreatitis.
title_full_unstemmed	Meandering main pancreatic duct as a relevant factor to the onset of idiopathic recurrent acute pancreatitis.
title_sort	meandering main pancreatic duct as a relevant factor to the onset of idiopathic recurrent acute pancreatitis.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/8f0814994f074ccea833b5770bf1e703
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Meandering main pancreatic duct as a relevant factor to the onset of idiopathic recurrent acute pancreatitis.

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