The pancreas from a surgical perspective: an illustrated overview

Abstract

: The human pancreas is a solitary retroperitoneal organ which can be found in the pararenal space. It receives its blood supply from both embryologic foregut and embryologic midgut sources and has both endocrine and exocrine functions. Its chief endocrine function is the regulation of serum glucose levels and its principal exocrine function is the production of digestive enzymes. The position of the pancreas and its anatomical relations make pancreatic surgery challenging and high-risk. This article aims to summarise the key aspects of the pancreas which are relevant to the surgeon/surgical trainee in a concise and easy-to-follow format. Firstly, we cover the anatomy of the pancreas including its relations, blood supply, innervation and ductal anatomy. We have focused on surgically relevant anatomy so that this article can help to refresh an individual’s knowledge prior to assisting in theatre. Secondly, we describe anatomical variants and their clinical implications, along with further illustrations. We hope that readers will feel better prepared to manage patients with these variants having read this article. Thirdly, we discuss the exocrine and endocrine functions of the pancreas in a concise format whilst also discussing the tumours which can arise from these groups of cells. We describe how these tumours commonly present and how they are typically managed. Finally, we include a short section on other surgically-relevant conditions which can affect the pancreas.