Abstract
Pancreaticoduodenectomy (Whipple operation) is still the only option to cure pancreatic adenocarcinoma, but pancreatic resection is complicated by several factors. The pancreas lies within the curve of the duodenum and extends transversely across the posterior wall to the spleen. The celiac trunk, superior mesenteric artery, and portal vein run entangled in the region because of embryological rotation of the gut. Understanding the stereological anatomy is difficult because the pancreatic head is fixed to the superior mesenteric artery by the plexus. This chapter discusses the surgical anatomy of the pancreas and possible vascular variations for performing pancreatic surgery.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Abbreviations
- AIPDV:
-
Anterior inferior pancreaticoduodenal vein
- ASPDA:
-
Anterior superior pancreaticoduodenal artery
- ASPDV:
-
Anterior superior pancreaticoduodenal vein
- GDA:
-
Gastroduodenal artery
- IPDA:
-
Inferior pancreaticoduodenal artery
- PIPDA:
-
Posterior inferior pancreaticoduodenal artery
- PLphI:
-
Pancreatic head plexus I
- PLphII:
-
Pancreatic head plexus II
- PSPDA:
-
Posterior superior pancreaticoduodenal artery
- PSPDV:
-
Posterior superior pancreaticoduodenal vein
- SMA:
-
Superior mesenteric artery
- SMA:
-
Superior mesenteric vein
References
Jennings RE, Berry AA, Strutt JP, Gerrard DT, Hanley NA. Human pancreas development. Development. 2015;142(18):3126–37.
Surgical KW. anatomy of the pancreas for limited resection. J Hepatobiliary Pancreat Surg. 2000;7(5):473–9.
Kimura W, Nagai H. Study of surgical anatomy for duodenum-preserving resection of the head of the pancreas. Ann Surg. 1995;221(4):359–63.
Murakami G, Hirata K, Takamuro T, Mukaiya M, Hata F, Kitagawa S. Vascular anatomy of the pancreaticoduodenal region: A review. J Hepatobiliary Pancreat Surg. 1999;6(1):55–68.
Ohigashi H, Ishikawa O, Eguchi H, Yamada T, Sasaki Y, Noura S, et al. Early ligation of the inferior pancreaticoduodenal artery to reduce blood loss during pancreaticoduodenectomy. Hepatogastroenterology. 2004;51(55):4–5.
Tempero MA, Malafa MP, Behrman SW, Benson AB 3rd, Casper ES, Chiorean EG, et al. Pancreatic adenocarcinoma, version 2.2014: featured updates to the NCCN guidelines. J Natl Compr Canc Netw. 2014;12(8):1083–93.
Kamisawa T, Ando H, Suyama M, Shimada M, Morine Y, Shimada H, et al. Japanese clinical practice guidelines for pancreaticobiliary maljunction. J Gastroenterol. 2012;47(7):731–59.
Gockel I, Domeyer M, Wolloscheck T, Konerding MA, Junginger T. Resection of the mesopancreas (RMP): a new surgical classification of a known anatomical space. World J Surg Oncol. 2007;5:44.
Sharma D, Isaji S. Mesopancreas is a misnomer: time to correct the nomenclature. J Hepatobiliary Pancreat Sci. 2016;23(12):745–9.
Acknowledgment
The authors thank Mr. Shinya Fukamachi for medical illustrations.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Sugimachi, K., Bekki, Y., Iguchi, T., Morita, M., Toh, Y., Takenaka, K. (2018). Surgical Anatomy of the Pancreas and the Periampullary Region. In: Tewari, M. (eds) Surgery for Pancreatic and Periampullary Cancer. Springer, Singapore. https://doi.org/10.1007/978-981-10-7464-6_1
Download citation
DOI: https://doi.org/10.1007/978-981-10-7464-6_1
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-10-7463-9
Online ISBN: 978-981-10-7464-6
eBook Packages: MedicineMedicine (R0)