Does the pancreas move with respiration?

Background and Aim: The pancreas is a retroperitoneal organ and has been classically considered to be immobile on respiration. Recent radiological studies assessing the mobility of the pancreas have challenged this traditional concept. The present study was conducted to assess the movement of pancreas with respiration using fluoroscopy, a simple and inexpensive method. Methods: Patients with chronic pancreatitis who had either pancreatic calcification evident on fluoroscopy or an indwelling pancreatic duct stent were studied. The movement of the pancreas was assessed under fluoroscopy by measuring the displacement of the stent or calcification in relationship to the spine in maximum inspiration followed by maximum expiration. Results: Twenty-two patients (mean age 35.45 +/- 11.29 years, 17 men) with chronic pancreatitis were included in the study. Ten patients had pancreatic calcification and 12 had an indwelling pancreatic duct stent (two in the dorsal duct, 10 in the ventral duct). In all patients, the pancreas moved downward in the craniocaudal direction on deep inspiration. Pancreatic excursion from maximum inspiration to maximum expiration ranged from 0.1 to 3.4 cm. In addition, a medial movement of the head of pancreas was also noted in most of the patients. On univariate analysis, no association was found between the range of movement and the age or sex of the patient, duration or etiology of disease, presence or absence of calcification, severity of ductal changes of chronic pancreatitis and the length or diameter of the pancreatic stent placed. Conclusions: The pancreas moves craniocaudally with respiration and the head moves medially on inspiration.