What comprises the plate-like structure between the pancreatic head and the celiac trunk and superior mesenteric artery? A proposal for the term "P-A ligament" based on anatomical findings.

Abstract:

:A plate-like structure is located posterior to the portal vein system, between the pancreatic head and roots and/or branches of two major arteries of the aorta: the celiac trunk and superior mesenteric artery. We aimed to clarify the distribution and components of this plate-like structure. Macroscopic examination of the upper abdomen and histological examination of the plate-like structure were performed on 26 cadavers. The plate-like structure is connected to major arteries (aorta, celiac trunk, superior mesenteric artery) and the pancreatic head; it contains abundant fibrous bundles comprising nerves, vessels, collagen fibers, and adipose tissue. Furthermore, it consists of three partly overlapping fibrous components: rich fibrous bundles (superior mesenteric artery plexus) fused to the uncinate process of the pancreas; fibrous bundles arising from the right celiac ganglion and celiac trunk that spread radially to the dorsal side of the pancreatic head and superior mesenteric artery plexus; and fibrous bundles, accompanied by the inferior pancreaticoduodenal artery, entering the pancreatic head. The plate-like structure is the pancreas-major arteries (aorta, celiac trunk, superior mesenteric artery) ligament (P-A ligament). The term "P-A ligament" may be clinically useful and can facilitate comprehensive understanding of the anatomy surrounding the pancreatic head and provide an anatomical basis for further pancreatic surgery studies.

journal_name

Anat Sci Int

authors

Muro S,Sirirat W,Ban D,Nagakawa Y,Akita K

doi

10.1007/s12565-020-00597-1

subject

Has Abstract

pub_date

2021-01-08 00:00:00

eissn

1447-6959

issn

1447-073X

pii

10.1007/s12565-020-00597-1

pub_type

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