Particularities of splenopancreatic complex

Abstract

Introduction. In the last years, there is an increase in the number of complex surgical procedures on the spleen and pancreas. This process couldn’t have gone unnoticed and eventually caused a growth of interest toward this abdominal cavity organ. Aim of the study. To evaluate the particularities of splenopancreatic complex. Materials and methods. The study was conducted using macroscopical dissection, abdominal ultrasonography (USG) and abdominal computer tomography (CT). The total number of dissected organs was 118 and included the spleen, pancreas and duodenum. Abdominal USG was performed in 239 patients and abdominal CT - in 257 patients who didn’t have splenic or pancreatic pathology. Results. The length of the pancreas correlated with the presence of accessory spleen (AS) (r=0.39; p=0.02) and inferior polar artery (r=0.37; p=0.037). Inferior polar arteries predicted the length of the pancreas although only a small number of cases could be explained by this model (R2=0.127, Adjusted R2=0.098; Betta=0.357; t(50)=2.091; p=0.045). The dimensions of the pancreas assessed by USG correlated significantly with the dimensions of the spleen. The tail of the pancreas had the strongest correlation (r= 0.33, p<0.001). During the anatomical dissection of 118 organ complexes, we encountered 12 cases of AS, which represents 10.6% of the total number of cases. The mean length was 1.67±1.03 cm, width 1.47±0.8 cm and thickness 0.87±0.52 cm. Among the 257 patients who had abdominal CT – 79 (30.73%) had AS (4 patients had two accessory spleens, 2 patients had three AS). Thus, from 79 patients – 92.4% had one AS, 5.1% had two AS and 2.5% had three AS. Conclusions. There are several important variants of development, which should be taken into consideration while operating in the region and AS and the presence of inferior polar arteries are one of them. The reason for this relationship is the presence of common vascular supply as well as common embryology.