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Ampulla of vater

Dr Yuranga Weerakkody et al.

The ampulla of Vater is a conical structure at the confluence of the common bile duct and the main pancreatic duct that protrudes at the major duodenal papilla into the medial aspect of the descending or horizontal duodenum. The entire structure is encased by smooth muscle fibers that compose the sphincter of Oddi 2.  It traverses a dehiscence of the duodenal wall and terminates at the major duodenal papilla.

Anatomical variations

Normally, the junction of the common bile duct (CBD) and the main pancreatic duct occurs in three ways 1

  • a common duct (the ampulla of Vater) : ~  60% 
  • a “double-barreled” opening at the apex of the papilla : ~  38% 
  • separate duodenal openings for the two canals : ~ 2% 
Related pathology
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