Clinical and Variant Anatomy of the Blood Supply to the Body and Tail of the Human Pancreas
https://doi.org/10.18499/2225-7357-2021-10-3-68-74
Abstract
The aim of the study was to specify peculiarities of the blood supply to the body and tail of the human pancreas determining topographic variants and vascular bed of the splenic artery.
Material and methods. The artery basin of the pancreas body and tail was studied in 46 native and 42 organ complexes consisting of the pancreas, duodenum, spleen, retropancreatic tissue, celiac trunk with the main branches, a section of the superior mesenteric artery up to the entrance into the root of the small intestine mesentery with the preliminary artery injection by gelatin mass. The organ complexes were fixed in 10% formalin solution.
Results. The study revealed two variants of the splenic artery topography in relation to the pancreas and determined the degree of tortuosity of the artery. In 31.7% of cases the vessel passed retro-pancreatically and in 68.3% suprapancreatically. Moderate tortuosity of the splenic artery was detected most frequently (44.82%); in 34.48% of cases severe tortuosity was detected; in 17.24% of cases there was no tortuosity in the artery. The correlation between area/convolution and the number of pancreatic arteries was found to be 0.864 (p=0.05), which is considered to be a high parameter according to the Cheddock scale. In severe tortuosity of the splenic artery 3.16±0.37 pancreatic arteries on average closed to the corpus caudal segment of the pancreas, in moderate tortuosity – 5.09±1.24, in straight passage – 9±1.22.
Conclusion. The regularities revealed in the spleen artery topography, blood supply of the pancreas body and tail allow determining operational risks and tactics of surgical interventions on the corpus caudal segment of the pancreas.
About the Authors
N. A. Pronin
I.P. Pavlov Ryazan State Medical University
Russian Federation
Russian Federation
Nikolai Pronin
ul. Vysokovol'tnaya, 9, Ryazan, 390026
A. V. Pavlov
I.P. Pavlov Ryazan State Medical University
Russian Federation
Russian Federation
Ryazan
E. V. Sekisova
I.P. Pavlov Ryazan State Medical University
Russian Federation
Russian Federation
Ryazan
G. S. Lazutina
I.P. Pavlov Ryazan State Medical University
Russian Federation
Russian Federation
Ryazan
N. V. Ovchinnikova
I.P. Pavlov Ryazan State Medical University
Russian Federation
Russian Federation
Ryazan
M. I. Ivanov
I.P. Pavlov Ryazan State Medical University
Russian Federation
Russian Federation
Ryazan
References
1. Barykov VN, Istomin AG, Abdrashitov RR, Ryzhikh AS. Immediate and long-term results of distal pancreatic resection. Permskiy meditsinskiy zhurnal. 2019;XXXVI(2):6–13 (in Russian). doi: 10.17816/pmj3626–13.
2. Gayvoronskiy IV, Kotiv BN, Kovalenko NA, Pelipas YuV, Bakhovadinova ShB, et al. Clinical significance of variant anatomy of the celiac trunk. Bulletin of the Russian Military Medical Academy. 2018;1(61):235–9 (in Russian)
3. Katelnitskiy II, Katelnitskaya OV. The role of vascular reconstructions in surgery of tumors of the hepatopancreatobiliary zone. IP Pavlov Russian Medical Biological Herald. 2019 Oct 8;27(3):385–92 (in Russian). doi: 10.23888/PAVLOVJ2019273385-392.
4. Kriger A.G., Karmazanovskii G.G. Diagnostika i khirurgicheskoe lechenie kistoznykh opukholei podzheludochnoi zhelezy: metod. rukovodstvo. Moscow, 2019 (in Russian).
5. Kriger AG, Kochatkov AV, Berelavichus SV, Lebedeva AN, Karel'skaya NA. Robotic assisted distal pancreatic resection for insulinoma. Pirogov Russian Journal of Surgery. 2011;(8):83–6 (in Russian).
6. Kurbonov КМ, Ruziboyzoda KR, Ali-Zade SG. Diagnosis and Treatment of Pancreatogenic Bleedings. Novosti Khirurgii. 2020 Dec 24;28(6):648–54. (in Russian). doi: 10.18484/2305-0047.2020.6.648.
7. International anatomical terminology (with an official list of Russian equivalents). Kolesnikov L.L., red. Moscow; 2003 (in Russian).
8. Neledova LA, Mizgiriov DV, Duberman BL. Hemorrhagic complications of pancreatitis in surgical practice. Grekov’s Bulletin of Surgery. 2019 Mar 28;178(1):55–8 (in Russian). doi: 10.24884/0042-4625-2019-178-1-55-58.
9. Pinchuk AV, Anisimov YA, Dmitriev IV, Storozhev RV, Balkarov AG, Muslimov RS, et al. The experience of pancreas transplantation with isolated splenic artery supply. Kazan medical journal. 2019 Dec 15;100(2):322–68 (in Russian). doi: 10.17816/KMJ2019-322.
10. Pronin NA, Pavlov AV, Natalsky AA, Tarakanov PV, Dronova EA. Anatomical variability of extraorganic pancreatic arteries. Operativnaya khirurgiya i klinicheskaya anatomiya (Pirogovskii nauchnyi zhurnal). 2020;4(1):26–31 (in Russian). doi: 10.17116/operhirurg2020401126.
11. Tarakanov PV, Sudakova IYu, Pavlov AV. Distinguishing features of the formation and topography of the pancreatic isthmus arterial trunks. Nauka molodykh (Eruditio Juvenium). 2018; 6 (2): 225–32 (in Russian). doi: 10.23888/ HMJ201862225-232.
12. Chichevatov DA, Kalentev VV, Glukhov AE. Arterial resection in pancreatic cancer surgery: a single-center experienc. Siberian journal of oncology. 2020 Oct 29;19(5):82–7 (in Russian). doi: 10.21294/1814-4861-2020-19-5-82-87.
13. Datta J, Vollmer CM. Advances in Surgical Management of Pancreatic Diseases. Gastroenterology Clinics of North America. 2016 Mar;45(1):129–44.. doi: 10.1016/j.gtc.2015.10.002.
14. Farghadani M, Momeni M, Hekmatnia A, Momeni F, Baradaran Mahdavi MM. Anatomical variation of celiac axis, superior mesenteric artery, and hepatic artery: Evaluation with multidetector computed tomography angiography. Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences. 2016 Dec 26;21:129. doi: 10.4103/1735-1995.196611.
15. Hackert T, Schneider L, Büchler MW. Current State of Vascular Resections in Pancreatic Cancer Surgery. Gastroenterology Research and Practice. 2015;2015:1–7. doi: 10.1155/2015/120207.
16. Klaiber U, Mihaljevic A, Hackert T. Radical pancreatic cancer surgery—with arterial resection. Translational Gastroenterology and Hepatology. 2019 Feb 3;4: 8. doi: 10.21037/tgh.2019.01.07.
17. Macchi V, Picardi EEE, Porzionato A, Morra A, Bardini R, Loukas M, et al. Anatomo-radiological patterns of pancreatic vascularization, with surgical implications: Clinical and anatomical study. Clinical Anatomy. 2017 May 10;30(5):614–24. doi: 10.1002/ca.22885.
18. Marangoni G, O’Sullivan A, Faraj W, Heaton N, Rela M. Pancreatectomy with synchronous vascular resection – An argument in favour. The Surgeon. 2012 Apr;10(2):102–6. doi: 10.1016/j.surge.2011.12.001.
19. Mosca S, Di Gregorio F, Regoli M, Bertelli E. The superior horizontal pancreatic artery of Popova: a review and an anatomoradiological study of an important morphological variant of the pancreatica magna artery. Surgical and Radiologic Anatomy. 2014 Mar 6;36(10):1043–9. doi: 10.1007/s00276-014–1276–8
Review
For citations:
Pronin N.A., Pavlov A.V., Sekisova E.V., Lazutina G.S., Ovchinnikova N.V., Ivanov M.I. Clinical and Variant Anatomy of the Blood Supply to the Body and Tail of the Human Pancreas. Journal of Anatomy and Histopathology. 2021;10(3):68-74. (In Russ.) https://doi.org/10.18499/2225-7357-2021-10-3-68-74
Views:
587
Email this article 