TOPOGRAPHY ANATOMY of PANCREAS

JEEVAN KISHORE

GROUP:-20

TBILISI STATE MEDICAL UNIVERSITY

PANCREASIT IS SOFT LOBULATED AND ELONGATED ORGAN…

IT LIES ON POSTERIOR ABDOMINAL WALL BEHIND THE PERITONEUM…

IT IS RETROPERITONEAL…

BOTH EXOCRINE AND ENDOCRINE GLAND…

EXOCRINE:-SECRETES ENZYME FOR HYDROLYZING

PROTEINS, FATS AND CARBOHYDRATES…

ENDOCRINE:-ISLETS OF LANGERHANS

PRODUCES HORMONE LIKE

INSULIN AND GLUCAGON FOR METABOLISM OF CARBOHYDRATE…

SURFACE…CROSS SECTION:- IT IS TRIANGULAR SHAPED…ANTERIOR, POSTERIOR AND INFERIOR SURFACES ARE SEEN…

POSTERIOR SURFACE:- APPLIED TO THE POSTERIOR ABDOMINAL WALL… NOT COVERED BY PERITONEUM…

ANTERIOR SURFACE:-COVERED BY PERITONEUM…

INFERIOR SURFACE:-COVERED BY PERITONEUM…

IT ALSO FACES THE INFRACOLIC COMPARTMENT OF GREATER SAC…

PERITONEUM FUSION:-THE PERITONEUM LAYER WHICH COVERS THE PANCREAS JOINS AND FORMS THE FUSED PERITONEAL LAYER OF POSTERIOR WALL OF LESSER SAC AND TRANSVERSE MESOCOLON…

AT THIS POINT MIDDLE COLIC ARTERY PASSES BETWEEN THESE 2 LAYERS AND REACHES TRANSVERSE MESOCOLON…

DUE TO THIS ARRANGEMENT OF MESENTERY THE SUPERIOR SURFACE OF THE PANCREAS LIE POSTERIOR TO LESSER SAC…

STRUCTURETHE HEAD:-SITS ON THE CURVE OF DUODENUM…

LIES ANTERIOR TO INFERIOR VENACAVA AND LEFT RENAL VEIN AND TRAVEL TO BILIARY DUCT…

SMALL PORTION OF HEAD LIES BELOW THE SUPERIOR MESENTERIC VEIN CALLED UNCINATE PROCESS…

JOINS TO BODY OF PANCREAS VIA NECK…

THE NECK:-OVERLIES THE MESENTERIC VESSELS AND THE PORTAL VEIN…

THE BODY:-EXTENDS TO THE LEFT TILL THE HILUM OF LEFT KIDNEY…

IT OVERLIES AORTA, LEFT RENAL VEIN, SPLENIC VESSELS AND TERMINATION OF INFERIOR MESENTERIC VEIN…

ANTERIOR SIDE IS CROSSED BY THE ATTACHMENT OF TRANSVERSE MESOCOLON…

THE TAIL:-IT PASSES FORWARD IN THE SPLENICO-RENAL LIGAMENT…

IT CONTACTS THE HILUM OF THE SPLEEN…

PANCREATIC DUCTTHE MAIN PANCREATIC DUCT:-PASSES TRANSVERSELY IN THE ORGAN AND OPEN INTO THE 2ND PART OF THE DUODENUM.

IT ALSO ACCOMPANIES BILE DUCT INTO THE 2ND PART OF THE DUODENUM…

THE ACCESSORY DUCT:-IT DRAINS THE UPPER PART OR THE LOWER PART OF HEAD OF PANCREAS INTO THE DUODENUM JUST ABOVE THE MAIN PANCREATIC DUCT ON THE MINOR DUODENAL PAPILLA…

THE ACCESSORY DUCT FREQUENTLY COMMUNICATES WITH THE MAIN DUCT…

BLOOD SUPPLY ARTERY:-HEAD OF THE PANCREAS SUPPLIED BY:-

SUPERIOR PANCREATIC-DUODENAL ARTERY

INFERIOR PANCREATIC-DUODENAL ARTERY

NECK, BODY AND TAIL IS SUPPLIED BY:-

BRANCHES OF SPLENIC ARTERY

VEINS:-PANCREATIC VEIN DRAINS IN THE PORTAL VEIN,

SPLENIC VEIN AND SUPERIOR MESENTERIC VEIN…

LYMPHATICSFLOWS IN DIRECTION OF BLOOD VESSELS TO PRE-AORTIC NODE AROUND CELIAC AND SUPERIOR MESENTERIC ARTERY…

INTERMEDIATE PANCREATICO-SPLENIC NODES ARE ALSO FOUND ALONG THE SPLENIC ARTERY AS IT TRANSVERSE THE UPPER BORDER OF PANCREAS…

ADENOCARCINOMAIT IS CAUSED BY TUMOR ASSOCIATED IN THE PANCREAS

TUMOR IN HEAD OF PANCREAS:-WHIPPLE OPERATION IS INDICATED

TUMOR ON OTHER PART OF PANCREAS:-RADICAL DISTAL PANCREATECTOMY IS INDICATED

WHIPPLE OPERATIONHEAD OF PANCREAS, PART OF BILE DUCT, GALL BLADDER, DUODENUM AND PART OF STOMACH IS REMOVED WHICH ARE AFFECTED BY TUMOR.

THEN REMAINING PART OF BILE DUCT, PANCREAS, INTESTINE AND STOMACH IS SUTURED INORDER TO DIRECT THE GI TRACT BACK IN THE GUT.

DISTAL PANCREATECTOMY BOTTOM HALF OF PANCREAS IS REMOVED DUE TO TUMOR IN BODY OR TAIL OF PANCREAS.

AFTER THE CUT EDGE IS SUTURED TO AVOID LEAKAGE OF PANCREATIC JUICE.