Blood supply to the pancreatic head, bile duct, and duodenum -: Evaluation by computed tomography during arteriography

Hypothesis: Blood supply to the peripancreatic region is derived from the celiac and superior mesenteric arteries, complementary to each other. Design: Cohort analytic study. Setting: Tertiary care public hospital. Patients and Methods: Computed tomography (CT) during superior mesenteric artery arteriography (SMAA-CT) and during celiac artery arteriography (CEAA-CT), in which a catheter tip was inserted into the common hepatic or gastroduodenal artery, was performed in 25 patients. Main Outcome Measure: Distribution and correlation of these areas of marked enhancement on SMAA-CT and CEAA-CT were analyzed. Results: The right cephalic part of the pancreatic head that is derived from the dorsal bud was enhanced on CEAA-CT, and the left caudal part of the pancreatic head that is derived from the ventral bud was enhanced on SMAA-CT. Blood supply to the intrapancreatic bile duct, including the ampulla of Vater, is derived from the CEA. The boundary between the areas of the duodenum supplied from the CEA and SMA was in the second or third portion. Conclusion: The pancreatic head can be separated into 2 segments by the arterial supply, and each segment may be removed separately.