Ampulla of Vater

Last revised by Dr Daniel J Bell on 13 Dec 2021

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

The confluence of the common bile and main pancreatic ducts may occur in three ways 1:

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

Named after Abraham Vater (1684-1751), a German professor of anatomy 5.  

The eponymous terms for both the ampulla and the papilla can be replaced with anatomical terms such as hepatopancreatic or biliopancreatic ampulla and major or greater duodenal papilla, respectively 6.

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Cases and figures

  • Figure 1: normal ampulla of Vater
    Drag here to reorder.
  • Case 1: ampulla of Vater on an upper GI
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