The main pancreatic duct (duct of Wirsung) runs the length of the pancreas from tail to head, collecting small side branches like the bones of a fish. In the head it turns down and back to join the common bile duct, usually forming the hepatopancreatic ampulla that opens at the major duodenal papilla. In the head it is normally about 3 mm wide, narrowing toward the tail.
| Location | Within the pancreas from the tail to the head, ending at the hepatopancreatic ampulla in the wall of the descending duodenum |
|---|---|
| Parts |
|
| Nerve Supply | Vagus nerve (parasympathetic, secretomotor); Greater and lesser splanchnic nerves via the coeliac and superior mesenteric plexuses (sympathetic and pain) |
| Blood Supply | Pancreatic branches of the splenic and pancreaticoduodenal arteries |
| Venous drainage |
|
| Lymphatic drainage |
|
Carries pancreatic juice from the whole gland to the duodenum.
Dilation of both the pancreatic duct and the common bile duct on imaging (the double duct sign) strongly suggests a tumour at the pancreatic head or ampulla. In chronic pancreatitis the duct may show alternating strictures and dilatations (chain of lakes) and contain stones. Disruption of the duct in pancreatitis or trauma leads to pseudocysts, pancreatic ascites or fistula.
Mucin-producing tumour that dilates the main pancreatic duct and carries a high risk of becoming invasive cancer.
Leak from the main duct after pancreatitis or trauma, causing pseudocyst, pancreatic ascites or pleural effusion.
Calcified stones blocking the duct in chronic pancreatitis, causing pain and worsening gland damage.
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