Surgical anatomy

The pancreas is an elongated abdominal glandular organ with both digestive (exocrine) and hormonal (endocrine) functions measuring about 15cm. It is located obliquely across the posterior abdominal wall at the level of the L1 and L2 vertebral bodies.

The pancreas is divided into four parts in which three are retroperitoneal (Head, neck and body) and one (The tail) is intra peritoneal.

Anatomical relations

Anterior aspect-stomach, transverse mesocolon, superior mesenteric artery.

Posterior aspect-Spleen, Aorta, inferior vena cava, right renal artery, right and left renal veins, superior mesenteric vessels, splenic vein, hepatic portal vein, left kidney, left suprarenal gland

Lateral aspect- Spleen

Medial aspect-Duodenum (descending and horizontal parts)

Pancreatic ducts

In the pancreatic parenchyma there is a dense network of small ducts which drain pancreatic juice into the main pancreatic duct. Main pancreatic duct is known as Wirsung duct which combines with the common bile duct at the hepatopancreatic ampulla (ampulla of Vater) which enters the descending part of the duodenum at the major duodenal papilla which contains the hepatopancreatic sphincter (sphincter of Oddi) which regulates secretion of bile and pancreatic fluid into the intestines.

Accessory pancreatic duct (duct of Santorini) drains pancreatic juice from main pancreatic duct directly into the duodenum at the minor duodenal papilla (located just above the major duodenal papilla) even in the absence of bile juice.