Duplicated ventral pancreatic ducts arising separately from the duodenal wall: anatomical evidence suggestive of persistence of the left ventral pancreatic bud.

PURPOSE: Human embryological studies have documented the transient presence of paired ventral pancreatic buds during early development. The persistence of the left ventral bud into adulthood could theoretically result in duplicated ventral pancreatic ducts in adulthood. Here, we report a case of duplicated ventral ducts incidentally observed in a human pancreas retrieved from an organ donor.

ANATOMIC VARIATION: The pancreas was obtained from a 46-year-old male donor after brain death for the purpose of islet transplantation. During the islet isolation procedure, we unexpectedly identified two ventral pancreatic duct orifices, side by side, near the entry point of the bile duct into the duodenum. The larger ventral duct was located posterior to the common bile duct. Macroscopic examination of the serosal side of the duodenum demonstrated that the two ventral ducts entered the duodenal wall separately. Investigation of the mucosal surface revealed that both ventral ducts and the common bile duct drained together into a single opening at the major duodenal papilla.

CONCLUSIONS: This is our first case of duplicated ventral pancreatic ducts arising separately from the duodenal wall in a series of over 2,600 cases, suggesting the persistence of the left ventral pancreatic bud. To our knowledge, direct macroscopic documentation of this specific configuration has not been previously reported. This finding expands the known spectrum of pancreatic ductal anomalies and provides novel anatomical insight into human pancreatic embryogenesis.