This retrospective study was conducted to evaluate the relationships between pancreas divisum, biliary duct anatomical variations and pancreaticobiliary tumors using magnetic resonance cholangiopancreatography (MRCP).

The MRCP examinations of 1628 patients were retrospectively reviewed for the presence of pancreas divisum, biliary duct anatomical variations and pancreaticobiliary tumors. Of these, 90 patients (31 men, 59 women) with a mean age of 62.6 years±15.8 (SD) (range: 22–101 years) had pancreas divisum. MRCP images were analyzed by two independent readers with discordances resolved by consensus opinion.

A total of 1538/1628 patients (94.5%) had a dominant duct of Wirsung; of them 54/1538 patients (3.5%) had pancreaticobiliary tumors. A total of 90/1628 patients had pancreas divisum; of them, 7/90 patients (7.8%) had pancreaticobiliary tumors, including intrapancreatic mucinous neoplasm (n=3), ampullary carcinoma (n=2), pancreas carcinoma and gallbladder carcinoma (n=1 each). Pancreaticobiliary tumors were more frequent in patients with pancreas divisum than in those with a dominant duct of Wirsung (P=0.0383).

The results of our study suggest that patients with pancreas divisum and biliary anatomical variations are more likely to develop pancreaticobiliary tumors and should be followed up closely using MRCP. However, our results should be confirmed by further prospective studies.