Vascular Supply: Important Arterial and Venous Variants

Abstract

The vascular anatomy of the pancreas permits its partial resection, thereby greatly enhancing life expectancy of patients with pancreatic cancer while limiting morbidity associated with a total pancreatectomy. Variations in arterial anatomy are common, directly relate to the embryology of the pancreas, and need to be understood by the surgeon to prevent inadvertent injury with potentially catastrophic consequences during resection. Variation in venous anatomy, while also common, are of lesser importance when planning standard resection. Differences in venous anatomy can, however, become relevant when planning venous resection and reconstruction.

This chapter describes normal pancreatic vascular anatomy in detail, while highlighting its common variants and their relevance to pancreatic resection providing points of clinical reference to aid understanding. This knowledge is essential in order to perform a standard pancreatic resection safely. An appreciation of specific anatomical variants and their implications may also allow alternate approaches when resecting locally advanced cancers.