Honselmann Kim C, Litkevych Stanislav, Sydorenko Mykhailo, Keck Tobias
Klinik für Chirurgie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburgerallee 160, 23538, Lübeck, Deutschland.
National Academy of Sciences of Ukraine, Kiev, Ukraine.
Chirurgie (Heidelb). 2025 Sep 9. doi: 10.1007/s00104-025-02367-z.
A profound understanding of pancreatic anatomy and its vascular supply is essential for safely performing complex surgical procedures such as pancreaticoduodenectomy. Historically, anatomical exploration began with Herophilos and Ruphos of Ephesos in ancient times, evolving through major surgical innovations by Wirsung, Kausch and Whipple. The pancreas is located secondarily retroperitoneally and therefore has a close relationship of the pancreatic head to the superior mesenteric artery (SMA) and portal vein (PV) and the celiac trunc. Clinically relevant anatomical variants, such as the Rio-Branco and Bühler anastomoses and various forms of the coeliac trunk according to Hiatt's classification are crucial for surgical planning. Venous drainage primarily occurs through the superior mesenteric vein, splenic vein and the gastrocolic trunk of Henle. The "artery first approach" provides various access routes to safely identify and expose critical vascular structures, to optimize oncological resection and minimize perioperative complications.
深入了解胰腺解剖结构及其血管供应对于安全地进行诸如胰十二指肠切除术等复杂外科手术至关重要。历史上，解剖学探索始于古代以弗所的希罗菲卢斯和鲁福斯，历经维尔松、考施和惠普尔的重大外科创新不断发展。胰腺位于腹膜后位，因此胰头与肠系膜上动脉（SMA）、门静脉（PV）和腹腔干关系密切。临床相关的解剖变异，如里奥 - 布兰科和比勒吻合术以及根据海特分类的各种形式的腹腔干，对于手术规划至关重要。静脉引流主要通过肠系膜上静脉、脾静脉和亨勒胃结肠干进行。“动脉优先入路”提供了各种进入途径，以安全地识别和暴露关键血管结构，优化肿瘤切除并减少围手术期并发症。
