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The ampulla of Vater, hepatopancreatic ampulla or hepatopancreatic duct is the common duct that is usually formed by a union of the common bile duct and the pancreatic duct within the wall of the duodenum. This common duct usually features a dilation ("ampulla").
It is surrounded by the sphincter of Oddi, a circular muscle, and receives a mixture of pancreatic enzymes and bile from the Ampulla of Vater, which drains both the pancreatic duct and biliary system. [2] The junction between the foregut and midgut occurs directly below the major duodenal papilla.
The sphincter regulates the secretion of pancreatic juice and bile into the duodenum. [3] It also prevents reflux of duodenal contents into the ampulla of Vater. [4] By preventing reflux of the contents of the duodenum, the sphincter of Oddi prevents the accumulation of particulate matter and sludge in the bile ducts, reducing the risk of cholangitis.
The path is as follows: bile canaliculi → canals of Hering → interlobular bile ducts → intrahepatic bile ducts → left and right hepatic ducts merge to form → common hepatic duct exits liver and joins → cystic duct (from gall bladder) forming → common bile duct → joins with pancreatic duct → forming ampulla of Vater → enters ...
The bile duct is some 6–8 cm long, and normally up to 8 mm in diameter. [4]Its proximal supraduodenal part is situated within the free edge of the lesser omentum.Its middle retroduodenal part is oriented inferiorly and right-ward, and is situated posterior to the first part of the duodenum, and anterior to the inferior vena cava.
The pancreatic duct joins the common bile duct just prior to the ampulla of Vater, after which both ducts perforate the medial side of the second portion of the duodenum at the major duodenal papilla. There are many anatomical variants reported, but these are quite rare. [2]
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Individuals with stenosis of the sphincter of Oddi typically have an elevated baseline pressure of the sphincter of Oddi, due to an anatomical problem that leads to narrowing of the sphincter, such as recurrent passage of gallstones through the ampulla of Vater, trauma to the sphincter from procedures such as endoscopic retrograde ...