The pancreas has complex arterial supplies. Therefore, special attention should be paid in pancreatic arterial intervention for patients with acute pancreatitis and pancreatic carcinomas[1]. Knowledge of pancreatic arterial anatomy and arterial territory is important not only to perform pancreatic arterial intervention, but to read the pancreatic angiography and cross-sectional image.

Study of blood vessels helps not only anatomists, also radiologists to interpret or perform various radiological techniques and specially transplantation surgeons to operate on particular region[2]. Causes for variations are due to differences in genetic, haemodynamic, race, evolutionary pattern and ontogenic development. In recent times, the trend in surgical procedure is to move towards minimal invasive surgery for reasons to reduce morbidity and mortality, if the patient is selected carefully and investigated properly. Knowledge of variations during surgery gives surgeons a sense of security [3].

The pancreas is an exocrine and endocrine gland whose vascular supply consists of branches from the celiac trunk and from the superior mesenteric artery (SMA). Each part of the gland is supplied by specific branches which, after entering the parenchyma, anastomose to form a dense vascular network necessary for pancreatic function [4].

The colon, on the other hand, is supplied by branches from the SMA and inferior mesenteric arteries (IMA), with the IMA distributed from the left half of transverse colon. The branches of these arteries form a long marginal arcade extending variably along the colon, and which may extend from the cecum to the sigmoid colon[5-6].

Although there is an anatomical supply pattern for the different organs and tissues, anatomical variations of the vascular system are very common, so it is essential for anatomists and surgeons to be aware of that.

The blood supply of pancreas was studied in 75 human specimens at Government Medical College, Kota for 01 Year. The specimen were dissected, the stomach structures were cleaned, ligated at the pyloric end of stomach, porta hapatis and at the end of 3rd part of duodenum. Pancreas was removed along with spleen and duodenum. After 24 hours, dissected, painted and allowed to dry. The specimen numbered and photographed. Morphometry of the pancreas refers to the measurement and analysis of the pancreas's size, shape, and structure using various techniques, often involving imaging or histological analysis.

All helical CT scans were performed with the use of a CT scanner [Hi Speed Advantage scanner (GE-Medical Systems, Milwaukee) or Lemage Supreme (GE-Medical Systems, Milwaukee)]. Helical scanning parameters were as follows; 120 kVp, 200–250 mA, 5 mm collimation, 1:1 pitch, and 2.5 mm overlapping reconstruction. Double-phase helical CT scans were performed at 5–15 and 40–45 s after the start of injection of 30%–50% contrast medium (Iopamidol 300 mgI/mL; Shering Germany).

Table No. 1: Length of Pancreas in cm

The length of pancreas was found to be increasing with fetal age, with more increase during 33 weeks to 40 weeks.

Table No. 2: Origin of Inferior Pancreaticoduodenal Artery

Superior Mesenteric Artery: This artery contributes to 97% of the data, suggesting it is the dominant vessel in this context. The Superior Mesenteric Artery supplies blood to a significant portion of the intestines (small intestine, parts of the colon, etc.).

Common Hepatic Artery: The Common Hepatic Artery is responsible for 3%, indicating that it plays a much smaller role compared to the Superior Mesenteric Artery in this specific context. The Common Hepatic Artery supplies blood to the liver, stomach, and duodenum.

Table No. 3: Incidence of Pre-Pancreatic Arcade

Present: The feature or structure in question is present in 4% of the cases. This suggests that the occurrence of this feature is relatively rare in the sample or population being studied.

Absent: The feature is absent in 96% of the cases, which shows that it is much more common for this particular feature to be missing.

Table No. 4: Anastomoses of Transvers Pancreatic Artery

In this context, the Inferior Pancreaticoduodenal Artery plays a much more significant role (95%) in blood supply compared to the 1st Jejunal Artery, which contributes to just 5%. This distribution likely reflects the importance of the pancreas and duodenum in digestive functions, with the jejunum having a secondary, but still important, role in absorbing nutrients from food.

The knowledge of variations of the pancreatic arteries and pancreatic arterial supply is important in planning transarterial interventions; infusion of protease inhibitor for acute pancreatitis, and infusion chemotherapy for pancreatic carcinoma. Especially, the pancreatic head has complex arterial supply. The vascular anatomy of peripancreatic artery is very complicated, especially pancreatic head. Some authors had reported the variation of peripancreatic arteries on angiography and pathologic findings [7-8]. In our study, the middle colic artery was arising from the common trunk with the peripancreatic artery in four cases. These variations are also important for transarterial intervention and should be careful to infuse drug into peripancreatic artery.

Recently, the reports about the detectability of the peripancreatic arteries and veins on postcontrast helical CT have been published [9-12]. However, the pancreatic arterial supply has not been investigated on radiological findings. We evaluated the pancreatic arterial supply using the CTA.

The diabetic group that was not treated with either insulin or extract exhibited severe necrosis as well as an absence of islet cells which could be as a result of destruction of these cells by streptozotocin, however, in the treated groups, there was a marked improvement in the islet cells proving that the extract may had promoted islet beta cell survival, preserved islet mass or stimulated the regeneration of endogenous pancreatic beta cells. This corresponds to studies carried out by[13]. The exact mechanism by which the extract preserved the beta and other pancreatic islet cells was not studied in the present research study, however, phytochemical analysis of n-hexane extract of Leptadenia hastata revealed the presence of steroids, cardiac glycosides, terpenes and triterpenoids. The presence of these compounds were reported by[14].

During preoperative study, a detailed observation of blood supply is needed. It enables surgeons for easy and safer approach of the organ. It helps to prevent ligation of wrong vessels leading to gangrene. In mobilization of pancreas as bleeding is a complication and it can be prevented by knowing the arterial variation Significance of arterial variation was observed in complex surgeries approaching the tail of the pancreas. Knowledge of this complex vascular supply of pancreas and branching variation may influent the effective treatment by transarterial interventions such as infusion of proteinase inhibitor for acute pancreatitis and infusion chemotherapy for pancreatic carcinoma.

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