Anatomical embryological posibilities for ventral and dorsal pancreatic resections

Abstract

Recently, ventral and dorsal pancreatic resections are considered the procedures of choice for low-grade malignant neoplasms. The anatomical structure of the head of the pancreas is currently controversial. The anatomy of the head of the pancreas was studied on 10 fresh and 10 fixed in formaline specimens, collected from cadavers with age between 18-85 years, without pancreatic injuries. Anatomical macropreparation, morphometry, histotoporaphy were performed as methods of the study. The apex of the uncinate process was considered as orientation for separation and penetration into the interpancreatic fissure. The presence of a loose fissure between this two pancreatic structures facilitates their separation. The ventral portion is adhered to the dorsal portion by means of perforating vessels only. The ventral portion is connected to the dorsal portion by loose tissue. After separation, the dorsal and ventral pancreatic surfaces are smooth and shiny. The ventral portion can be removed without affection for the duodenal blood circulation. A complete fusion between the ventral and dorsal pancreas is determined only in the 1/3 superior part of the head of the pancreas. The main blood source for the ventral portion of the pancreas is presented by anterior pancreatoduodenal arcade. The ventral and dorsal pancreatic resections are argumentated anatomically and embryologically.