Structure of the pancreas

Learning outcomes
1. Describe the location, parts and the duct system of the pancreas

2. Describe its important anatomical relations.

3. Describe its arterial supply and venous drainage 4. Describe the microscopic arrangement of its exocrine and endocrine secretary units

Pancreas
Mixed exocrine endocrine gland lies transversely in the posterior abdominal wall ( L1 & L2 level)

Retroperitoneal
Divided in to head, neck, body& tail

Pancreas - relations

Head lies in the C shaped

concavity of the duodenum.

IVC & bile duct lie behind head.

Neck is very short. Portal vein is formed behind the neck. Body lies in front of the aorta,

left renal artery & left suprarenal gland.

Tail lies in front of the left kidney & is related to

Pancreas duct system

Main pancreatic duct extends from tail towards the head.

Joins with the bile duct to form the hepatopancreatic ampulla ( of Vater) Opens into the descending part of duodenum at major duodenal papilla. Occasionally both ducts open separately

Accessory duct when present communicate with the main duct. It opens to minor duodenal papilla

Pancreas duct system

Smooth muscle sphincters control flow of bile and pancreatic fluid into duodenum.
Hepatopancreatic sphincter ( of Oddi) Pancreatic duct sphincter Bile duct sphincter

Pancreas Arterial supply 1. From the coelic artery branches of the splenic artery

Common hepatic artery

superior pancreaticoduodenal artery ( branch of gastroduodenal artery) 2. From superior mesenteric A. inferior pancreatico duodenal artery

Pancreas Venous drainage

Veins accompany the arteries and drain to

splenic vein superior mesenteric vein Join to form the portal vein

Exocrine Pancreas
Arranged as acini Intercalated ducts penetrate the acini Basement membrane

around the acini

Acinar cells have zymogen granules

secrets proteases, lipase

and amylases

Pancreatic acini islets of Langerhans

Endocrine Pancreas
Rounded cluster of cells arranged as islets

More than million of islets

More abundant in the tail region Islet cells arranged as cords & clumps In between capillaries

Endocrine Pancreas

Four types of islet cells A cells ( alpha cells) - 20% B cells ( beta cells) - 70% D cells ( delta cells ) - 5%

F cells less than 5%

Endocrine Pancreas
A cells Glucagon increases blood glucose by glycogenolysis ,lypolysis & gluconeogenesis B cells - Insulin reduces blood glucose

D cells Somatostatin -

inhibits the release of other

islet cell hormones

F cells pancreatic polypeptides controls gastric secretions Tumors can arise from islet cells B cell tumors being the commonest ( insulinoma) Reduce insulin leads to diabetes mellitus