Surgical Anatomy of the Pancreas and the Periampullary Region

  • Keishi Sugimachi
  • Yuki Bekki
  • Tomohiro Iguchi
  • Masaru Morita
  • Yasushi Toh
  • Kenji Takenaka


Pancreaticoduodenectomy (Whipple operation) is still the only option to cure pancreatic adenocarcinoma, but pancreatic resection is complicated by several factors. The pancreas lies within the curve of the duodenum and extends transversely across the posterior wall to the spleen. The celiac trunk, superior mesenteric artery, and portal vein run entangled in the region because of embryological rotation of the gut. Understanding the stereological anatomy is difficult because the pancreatic head is fixed to the superior mesenteric artery by the plexus. This chapter discusses the surgical anatomy of the pancreas and possible vascular variations for performing pancreatic surgery.


Surgical anatomy Pancreas Anomaly Artery 



Anterior inferior pancreaticoduodenal vein


Anterior superior pancreaticoduodenal artery


Anterior superior pancreaticoduodenal vein


Gastroduodenal artery


Inferior pancreaticoduodenal artery


Posterior inferior pancreaticoduodenal artery


Pancreatic head plexus I


Pancreatic head plexus II


Posterior superior pancreaticoduodenal artery


Posterior superior pancreaticoduodenal vein


Superior mesenteric artery


Superior mesenteric vein



The authors thank Mr. Shinya Fukamachi for medical illustrations.


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Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Keishi Sugimachi
    • 1
    • 2
  • Yuki Bekki
    • 2
  • Tomohiro Iguchi
    • 1
  • Masaru Morita
    • 1
  • Yasushi Toh
    • 1
  • Kenji Takenaka
    • 2
  1. 1.Department of Hepatobiliary-Pancreatic SurgeryNational Kyushu Cancer CenterFukuokaJapan
  2. 2.Department of SurgeryFukuoka City HospitalFukuokaJapan

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