To Study The Relation Of Blood Vessels On The Back Of Pancreas As Well As Blood Supply Of Pancreas Anatomically

Purpose:Through dissecting the blood vessels on the back of pancreas,we can familiarize and grasp the origin,line,distribution and relation of the blood vessels .And we measure them to offer reference for clinical surgery.Method:On the 20 adult bodies specimens fixed by formalin ,we observe and measure the blood vessels on the back of pancreas.We adopt straightedge,tape measure,caliper,sliding and so on(the accurate degree is 0.02mm).Then we count and analyze the results by software SPSS10.0.At the same time,we photograph the important aspects and structure.Result:1.The probability of superior pancreaticoduodenal artery is only 35%,yet the inferior pancreaticoduodenal artery's is 70%.Anterior superior pancreaticoduodenal artery,posterior superior pancreaticoduodenal artery,anterior inferior pancreaticoduodenal artery,posterior inferior pancreaticoduodenal artery,the anterior and posterior artery arches composed with them in the head of pancreas are eternally. 2.Anterior and posterior artery arches in the head of pancreas are common blooding supply for head of pancreas and duodennum.The two arches are parallet to descending part of duodenum basically.Puodenal papilla is most protruding.The distances are 10-15mm and 15-20mm separately.The two arches send many branches to duodenum.The anterior artery arch has 9-14 branches,then the posterior artery arch has 12-15 branches.There are abundant combinations among the branches. 3.duodenal papilla artery:It is one second class branch from posterior artery arch and its probality is 80%(16/20).It goes into duodenal papilla accompanied with commonbileduct.It is on the right of commonbileduct.The distance between the outset and Vater's ampulla is (12.3+1.4)mm(10.4mm-17.0mm).4.uncinate process artery :Its probality is 70%(14/20).Its blooding supply comes from one descending branch (uncinate process) of dorsal pancreatic artery's right branch.It descends among superior mesenteric artery and vein and uncinate process.It conforms many combination with branches of anterior and posterior artery arches in the head of pancreas. 5.Superior mesenteric vein and splenic vein join into hepatic portal vein in the rear of pancreas neck.Their angle is 110-120 degrees.The level distance between the right edge of superior mesenteric vein and the head of pancreas is (38.6+3.7)mm.Superior mesenteric artery is on the left of the vein.The distance between the centers of the two blood vessels is (15.37+3.30)mm.6.Splenic artery stretches left along the pancreas's back.Splenic vein stretches in the vein groove closely near the back edge of pancreas.The position relation of splenic artery and vein is eternally.Splenic vein is always posterior inferior to splenic artery.7.Dorsal pancreatic artery originates from splenic artery.It changes into two branches in the neck or body of pancreas.The right branch is shorter and smaller and combinates with anterior and posterior artery arches in the head of pancreas.The left branch stretches left along the back of body of pancreas and changes into inferior pancreatic artery.The left branch runs through the whole length of body and tail of pancreas basically. Conclusion:1.pancreas's blooding supply comes from celiac artery,superior mesenteric artery and splenic artery.The arteries of pancreas have abundant combinations.The major arteries in head of pancreas near the descending part of duodenum,conforming anterior and posterior pancreaticoduodenal artery arch.The two arches send out many thin and small branches to supply for head of pancreas and duodenum.2.Duodenal papilla artery is one second class branch which comes from the right wall of posterior artery arch in the head of pancreas.Its loss will cause the papilla's blooding obstacle and Vater ampulla's functional obstacle.3.The arteries inside the head of pancreas display stratification and are regional obviously.As the mainstay of pancreatic duct as doundary,the essence of pancreas is divided into light layer and deep layer.The former organization is light layer,the back is deep layer.Light layer is supported by the branch from anterior artery arch,yet deep layer by the posterior artery arch.On the plane the pancreatic duct,there are abundant communicating branches between light and deep layers.4.Dorsal pancreatic artery originates from splenic artery,and changes into two branches.One branch of the right branch supplies blooding for uncinate process and combinates with anterior and posterior artery arches in the head of pancras,.The left branch stretches left along the back of pancreas and changes into inferior pancreatic artery.It runs through the whole length of body and tail of pancraes and is the biggest blooding artery of them.5.There are lots of important vessels and visceras around pancreas.Superior mesenteric vein and splenic vein join into hepatic portal vein in the neck of pancreas.Splenic vein stretches along the superior edge of tail of pancreas mostly.Left renal vein is inferior posterior to pancreas.Left renal vein joins into inferior vena cava between abdominal aorta and superior mesenteric artery.6.The key in the pancreaticoduodenal resecting surgery is eroding degree from tumor on head of pancreas to superior mesenteric vein and hepatic portal vein.The pancreas's resecting line is on the left of abdominal aorta to avoid injurying the left branch of dorsal pancreatic artery which will cause blooding obstacle of body and tail of pancreas.7.The key in DPPHP is to make one suturing line inside the duodenal flexure with 1.0cm.It can protect anterior and posterior artery arches in the head of pancreas and their branches into duodenum.Scoop out the tumor inside the line.Take care of inferior pancreaticoduodenal artery and first jejunal artery to avoid lacking blooding in inferior part of duodenum.8.As the result of it that the length of superior mesenteric vein and hepatic portal vein is obviously longer diameter(up to down) of neck of pancreas,it is possible to resect all the tumor in head of pancreas together with regional vessels that have some length.9.Take care of retaining right branch of dorsal pancreatic artery in the surgery for resecting body and tail of pancreas.10.Vessels supplying blood to pancreas are thin,so in LAI we should combine concentrating and super-concentrating to heighten effect.