Why is it so important to understand the anatomy of the pancreas and its surrounding structures?

Due to its location, pathologies of the pancreas are particularly difficult to identify and manage, furthermore, its partially retroperitoneal and intraperitoneal location creates numerous challenges in surgical approaches.

The pancreas is an important accessory digestive organ, producing both endocrine and exocrine secretions, regulating the digestion of foods as well as controlling blood glucose levels. Pancreatic cancer is one of the most difficult conditions to treat due to its asymptomatic presentation in its early stages, as well as the complex anatomical relationships that surround the pancreas which contributes to the difficulties in early diagnosis.

 

Data generated by the National Cancer Data Base estimates that the 5-year survival rate for those diagnosed with stage IA exocrine pancreatic cancer is 14% which dramatically drops to 1% for those diagnosed with stage IV cancer. The survival rate is more optimistic for patients who received surgical intervention for endocrine pancreatic cancer with a 61% 5-year survival rate in stage I cancer and a 16% survival rate in stage IV cancer.

 

 

Although symptoms for pancreatic cancers can often be non-specific, here are some symptoms which often present in those suffering from either exocrine or endocrine pancreatic cancers

Exocrine Pancreatic Cancer

  • Jaundice related symptoms
  • Abdominal pain – either in the belly or as back pain
  • Weight loss and poor appetite
  • New onset Diabetes
  • Unexplained pancreatitis

Endocrine Pancreatic tumors and cancers are mostly non-functional (ie do not procedure any hormones). These are typically asymptomatic, however, symptoms are more commonly associated with the unregulated secretion of pancreatic hormones when the endocrine tumor is functional.

  • Gastronomas
  • Glucagonomas
  • Insulinomas
  • Somatostatinomas
  • Pancreatic-polypeptide-omas (PPomas)

Pancreatic surgical access differs depending on the location of the pathology, therefore a good knowledge of the surrounding anatomy, including the divisions of the pancreas and its neurovasculature, is essential to understand the complexity not only of the surgical treatment of pancreatic cancer, but hepatopancreaticobiliary surgeries in general.

Review our new Pancreatic Anatomy procedure now available on the Touch Surgery App to learn how hepatopancreaticobiliary key opinion leader Dr. Adnan Alseidi introduces the complex anatomy of the pancreas.