Study of variations in the origin and branching of the human dorsal pancreatic artery

In surgical practice, the human pancreas is conventionally divided into two major anatomical and surgical segments: the right (cephalo-cervical) and the left (corpore-caudal). Both of these segments are abundantly supplied with blood. The artery-first approach is widely used in pancreatic resections to avoid venous stasis and achieve reduced blood loss. The dorsal pancreatic artery participates in the blood supply of both segments with its branches, which makes its anatomical study relevant and promising for clinical medicine. The aim was to describe the main branches of the dorsal pancreatic artery and to determine the frequency of their occurrence in the studied cases. Materials and Methods. The work was performed on archival fixed material (n = 60) of duodenum-pancreas-spleen organ complexes with extra-organ vessels taken from the collection of the Department of Anatomy, RyazSMU. All organ complexes belonged to mature age people without pronounced pathology of the organs of the investigated area. The division by sex was not performed. Results. The dorsal pancreatic artery was identified in all cases studied. Most often (n = 40; 67%) it originated from the branches of the ventral trunk, less often (n = 18; 30%) it was a branch of the superior mesenteric artery and in two cases (3%). Despite the place of origin, its trunk diameter averaged 1.8 mm (min 1.6; max 2.0). The branches of this artery were most often directed towards the gland body (85% of cases), less often - towards the head (15%). Conclusion. The dorsal pancreatic artery is the main artery feeding the body and tail of the human pancreas. In the present study, its branches were more frequently recorded towards the body of the gland, despite the origin of the vessel. Despite the accumulated anatomical and clinical knowledge about the peculiarities of the origin and branching of the human dorsal pancreatic artery, the understanding of the principles of the direction of its branches remains open to researchers.

pancreas, blood supply, arteries, dorsal pancreatic artery, branches

1. Kriger A. G., Gorin D. S., Pavlov A. V. et al. Distal resection for pancreatic tumors. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2022;27(3):55-62. (In Russ.) doi: 10.16931/1995-5464.2022-3-55-62.@@ Кригер А. Г., Горин Д. С., Павлов А. В. с соавт. Дистальная резекция при опухолях поджелудочной железы. Анналы хирургической гепатологии. 2022;27(3):55-62. doi:10.16931/1995-5464.2022-3-55-62.

2. Okahara M., Mori H., Kiyosue H., et al. Arterial supply to the pancreas; variations and cross-sectional anatomy. Abdominal Imaging. 2010;35(2):134-142. doi: 10.1007/s00261-009-9581-0.

3. Sharma S., Sureka B., Varshney V. et al. MDCT evaluation of Dorsal Pancreatic Artery and Intrapancreatic arcade anatomy. Surg Radiol Anat. 2023;45:1471-1476. doi: 10.1007/s00276-023-03235-3.

4. Rousek M., Whitley A., Kachlík D. et al. The dorsal pancreatic artery: A meta-analysis with clinical correlations. Pancreatology. 2022;22(2):325-332. doi: 10.1016/j.pan.2022.02.002.

5. Bezerra A.J., Didio L. J., Piva-Júnior L. Biographical data on the anatomist: Jean Léo Testut (1849-1925). Bull Assoc Anat (Nancy). 1991;75(229):145-149.

6. Woodburne R.T., Olsen L. L. The arteries of the pancreas. Anat Rec. 1951 Oct;111(2):255-70. doi: 10.1002/ar.1091110209.

7. Michels N. A. Newer anatomy of the liver and its variant blood supply and collateral circulation. Am J Surg. 1966 Sep;112(3):337-47. doi: 10.1016/0002-9610(66)90201-7.

8. Yamane M., Ishikawa Y., Asano D. et al. Surgical anatomy of the dorsal pancreatic artery: Considering embryonic development. Pancreatology. 2023;23(6):697-703. doi: 10.1016/j.pan.2023.07.009.

9. Pronin N.A., Pavlov A. V., Natal’skiĭ A.A. et al. Anatomical variability of extraorganic pancreatic arteries.Russian Journal of Operative Surgery and Clinical Anatomy. 2020;4(1):26-31. (In Russ.)@@ Пронин Н. А., Павлов А. В., Натальский А. А. и соавт. Анатомическая изменчивость экстраорганных артерий поджелудочной железы. Оперативная хирургия и клиническая анатомия (Пироговский научный журнал). 2020;4(1):26-31. doi: 10.1016/j.morpho.2021.04.002.

10. Horiguchi A., Ishihara S., Ito M. et al. Multislice CT study of pancreatic head arterial dominance. J Hepatobiliary Pancreat Surg. 2008;15(3):322-326. doi: 10.1007/s00534-007-1261-2.

11. Boscà-Ramon A., Ratnam L., Cavenagh T. et al. Impact of site of occlusion in proximal splenic artery embolisation for blunt splenic trauma. CVIR Endovasc. 2022;5(1):43. Published 2022 Aug 20. doi: 10.1186/s42155-022-00315-0.

12. Matsumura H. The significance of the morphology of the dorsal pancreatic artery in determining the presence of the accessory right hepatic artery passing behind the portal vein. Kaibogaku Zasshi. 1998 Oct;73(5):517-27.

13. Тsutsumi M., Arakawa T., Terashima T. et al. Morphological analysis of the branches of the dorsal pancreatic artery and their clinical significance. Clin Anat. 2014;27(4):645-652. doi: 10.1002/ca.22331.

14. Tatsuoka T., Noie T., Noro T. et al. Dorsal Pancreatic Artery - a Study of Its Detailed Anatomy for Safe Pancreaticoduodenectomy. Indian J Surg. 2021;(83):144-149. doi: 10.1007/s12262-020-02255-2.

15. Tarasenko S. V.V., Tarakanov P. V., Natalsky A. A. et al. Choice of the optimal level of pancreas crossing taking into account variants of arterial vessels and pancreatic duct topography. Surgical News. 2021. 29(2): 175-182. (In Russ.) doi: 10.18484/2305-0047.2021.2.175.@@ Тарасенко С. В., Тараканов П. В., Натальский А.А и соавт. Выбор оптимального уровня пересечения поджелудочной железы с учетом вариантов топографии артериальных сосудов и панкреатического протока. Новости хирургии. 2021. 29(2): 175-182. doi: 10.18484/2305-0047.2021.2.175.

16. Kriger A. G., Pronin N. A., Dvukhzhilov M. V. et al. Surgical glance at pancreatic arterial anatomy. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2021;26(3):112-122. (In Russ.) doi: 10.16931/1995-5464.2021-3-112-122.@@ Кригер А. Г., Пронин Н. А., Двухжилов М. В. и соавт. Хирургический взгляд на артериальную анатомию поджелудочной железы. Анналы хирургической гепатологии. 2021;26(3):112-122. doi: 10.16931/1995-5464.2021-3-112-122.

17. Ironside N., Barreto S. G., Loveday B. et al. Meta-analysis of an artery-first approach versus standard pancreatoduodenectomy on perioperative outcomes and survival. Br J Surg. 2018 May;105(6):628-636. doi: 10.1002/bjs.10832.