Surgical anatomy of arteries running transversely in the pancreas, with special reference to the superior transverse pancreatic artery.
OBJECTIVE
In pancreatic surgery, the pancreas is usually divided over the portal vein. Knowledge of transversely oriented arterial systems within the pancreas that would need to be ligated in most forms of pancreatic surgery is clinically important. We studied the anatomy of arteries running transversely in the pancreas.


METHODS
Thirty-eight cadavers donated for education and research were examined. The parenchyma of the pancreas was removed gradually from both the ventral and dorsal sides to reveal these arteries. Arteries at least 0.5 mm in diameter were sketched and counted.


RESULTS
The mean number of divided arteries over the portal vein at least 0.5 mm in diameter per specimen was 2.5 +/- 1.1 (range 1 to 5). The divided arteries were mainly transverse pancreatic (TP), superior TP, and dorsal pancreatic (DP) arteries. The superior TP artery was observed in 24/38 specimens (63.2%) and ran along the superior ventral side of the head of the pancreas in 79.2% of specimens. The superior TP artery was formed between the gastroduodenal (GD) and DP arteries in 15/38 specimens (39.5%). In pancreatic surgery, surgeons need to be aware of the anatomy of the superior TP artery. The TP artery usually originated from the GD artery and its branches. The TP artery joined with the DP artery in 61.3% of specimens and ran along the inferior surface of the body and tail of the pancreas. The TP artery frequently anastomosed with the great pancreatic artery. Arterial catheters for continuous delivery of protease inhibitors in acute necrotizing pancreatitis should be placed into the GD artery, because this will achieve perfusion of the entire pancreatic parenchyma.


CONCLUSIONS
We termed the artery originating from the GD or DP arteries, located at the cranial side of the head of the pancreas, the superior TP artery. Surgeons should pay close attention to the anatomy of the superior TP artery during pancreatic surgery.
Kimura
Wataru
W
First Department of Surgery, Graduate School of Medicine University of Yamagata, Yamagata, Japan. wkimura@med.id.yamagata-u.ac.jp
Hirai
Ichiro
I
Yamaguchi
Hiroshi
H
Wakiguchi
Sadae
S
Murakami
Gen
G
Kimura
Yuko
Y
D001158:Arteries / Q000033:anatomy & histology; D002102:Cadaver; D006801:Humans; D010179:Pancreas / Q000098:blood supply* / Q000601:surgery*; D010781:Photography