Features of the blood supply to the pancreas. Human duodenum The gastric artery is a branch of the celiac trunk

L HER-1/EGFR - cancer of the lung, pancreas, breast, gliomas, ovarian cancer.

V2: Axillary artery. Arteries of the upper limb. Abdominal aorta.

The first group is the arteries of the head of the pancreas.

Superior posterior pancreaticoduodenal artery(a. pancreaticoduodenalis superior posterior) in most cases departs from the gastroduodenal artery (diameter 1.5 - 3 mm).

When leaving above the head of the pancreas, the superior posterior pancreaticoduodenal artery descends in front of the common bile duct in the direction from left to right and goes almost horizontally at the level of the head; when it departs below the upper edge of the pancreas, it rises up and to the right, bending around its head.

Inferior anterior or posterior pancreaticoduodenal artery(a. pancreaticoduodenalis inferior posterior s. anterior) in most cases departs from the superior mesenteric artery and can be either anterior or posterior (diameter 0.5 - 1 mm).

The inferior posterior pancreaticoduodenal artery is located in the groove or, more often, 2.5 mm medially from it - on the posterior surface of the pancreatic head. Then the lower posterior pancreaticoduodenal artery goes to the right and up, forming an anastomotic arch with the upper artery of the same name. From this arc, with an interval of 0.8 - 1.2 cm, 3 - 6 branches depart to the pancreas and duodenum.

Superior anterior pancreaticoduodenal artery(a. pancreaticoduodenalis superior anterior) almost always departs from the gastroduodenal artery, which, as you know, gives, in addition to it, the right gastroepiploic artery behind the lower edge of the upper part of the duodenum. On the anterior surface of the pancreas, the artery goes to the lower flexure of the duodenum and, bending around the right edge of the pancreatic head, disappears under its lower edge.

Located in the thickness of the head of the pancreas, 1.5 - 2.5 cm medially from the anterior pancreaticoduodenal sulcus, the superior anterior pancreaticoduodenal artery anastomoses with the inferior anterior artery of the same name. In total, two branches depart from it to the duodenum and 2 - 3 branches to the pancreas.

From initial department of this artery depart in opposite directions a. duodenopylorica and a. pancreatica longa. These arteries may also originate directly from the gastroduodenal artery. A. duodenopylorica (diameter 1 - 2.5 mm) goes up and to the right, along the lower edge of the upper part of the duodenum to the pylorus. A. pancreatica longa (diameter 1 - 1.5 mm) forms the right side of the superior arterial arch. It goes around the tubercle of the pancreas, along its lower edge, to the left, towards the branch starting from the large pancreatic artery (splenic branch).

Own artery of the head of the pancreas (a. capitis pancreatis propria) departs from the dorsal pancreatic artery (from the splenic). The proper artery of the pancreatic head with the superior anterior pancreaticoduodenal artery form the sagittal anastomotic arcade of the head.

The second group is the arteries of the body and tail of the pancreas.

They depart from the splenic and gastroduodenal arteries, from the left gastroepiploic or right gastroepiploic, from the superior mesenteric, from the common hepatic, from the celiac trunk and, in isolated cases, from the accessory hepatic artery and from the short arteries of the stomach.

dorsal pancreatic artery(a. pancreatica dorsalis). It gives from 1 to 4 branches to the head of the pancreas, and then goes anterior or posterior from the splenic vein to the neck of the pancreas.

Great pancreatic artery(a. pancreatica magna) almost always departs from the right half of the splenic artery in the form of one, two or even three trunks. As a rule, it goes to the body of the pancreas in front of the splenic vein.

Inferior anterior pancreatic artery(a. pancreatica inferior anterior) - a long pancreatic artery. It almost always departs from the gastroduodenal artery.

Superior anterior pancreatic artery(a. pancreatica superior anterior) always departs from the gastroduodenal artery. It supplies blood to the cervix and the right half of the body of the pancreas. This artery, together with the inferior anterior pancreas, are the only major arteries supplying the neck of the pancreas.

Border pancreatic artery(a. pancreatica terminalis). Always departs from the splenic artery and is directed in most cases in front of and only sometimes behind the splenic vein. Its branches are distributed on the border between the body and tail of the pancreas.

Artery of the tail of the pancreas(a. caudae pancreatis). It departs from the splenic artery, from its branches and from the left gastroepiploic artery equally often, and in isolated cases from the short arteries of the stomach. This artery always forms arterial anastomoses with other branches of the pancreas located along its upper and lower edges. These marginal arterial anastomoses of the pancreas, together with the pancreatic-duodenal arcades of the head, form the peripancreatic arterial circle, from which branches extend along the anterior and posterior surface of the pancreas. The anastomoses between these branches constitute a spatial three-dimensional intraorganic arterial network.

Thus, in the region of the head, the posterior, middle and anterior superior, posterior and anterior inferior pancreaticoduodenal arteries, as well as the own artery of the pancreatic head, are the most constant; in the area of the body and tail - the dorsal, large, border pancreatic arteries, tail artery, anterior superior and anterior inferior pancreatic arteries.

Extraorganic and intraorganic anastomoses of the pancreas are formed by intersystem (branches of the celiac trunk and superior mesenteric artery) and intrasystemic (branches of the celiac trunk) connections.

Gastric branches of the splenic artery.

Unlike the pancreas, these branches are more permanent and start from the splenic artery closer to the hilum of the spleen.

Left gastroepiploic artery(a. gastroepiploica sinistra) departs from the splenic, less often on its own, more often by a common trunk: gastro-pancreatic-splenic or gastro-splenic, from which the branches also go to the spleen and pancreas.

The length of the left gastroepiploic artery ranges from 3 to 25 cm, and from the short left gastroepiploic artery 6 - 7 short trunks depart to the stomach, and from the long one - only 1 - 3.

The trunk of the left gastroepiploic artery can be conditionally divided into three sections: a) retrogastric (located in the duplication of the peritoneum, passing from the pancreas to the spleen); b) intraligamentous (in the gastrocolic ligament) and c) terminal section. Branches to the pancreas may depart from the retrogastric region; from the intraligamentous - short branches to the stomach and 2 - 3 branches to the greater omentum. The end section of the artery gives off 5 to 12 branches to its anterior and posterior walls and anastomoses with the right gastroepiploic artery.

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The pancreas is a delicate glandular structure located behind the stomach. Its projection is well shown in Fig. 4. It is located above the navel, which is taken into account during palpation. The tail part goes to the left hypochondrium to the upper pole of the kidney. The anterior surface of the gland is covered with a delicate sheet of peritoneum and forms the posterior wall of the gastro-omental sac. The back surface is turned into the retroperitoneal space to the spine. The upper and lower edges of the pancreas are as if pointed.

Rice. 4. Projection of the pancreas on the anterior wall of the abdomen

Four parts of the pancreas should be distinguished: head, isthmus, body, and tail (Fig. 5). On the posterior surface of the head, at the lower edge, the hook-shaped process (processus uncinotus s. pancreas Winslowi) extends downward to the left and somewhat anteriorly. At the place of origin of the process, a kind of notch is formed on the inside. Particularly important large blood vessels pass through this notch. The tip of the uncinate process is woven into the connective tissue formations near the spine.

Rice. 5. Parts of the pancreas:
1 - head; 2 - isthmus; 3 - body; 4 - tail; 5 - uncinate process

The pancreas is located behind the fatty tissue, but nevertheless it is not very mobile in the tissues. This immobility is primarily due to the ligamentous apparatus extending from the uncinate process. This ligamentous apparatus, passing through the parapancreatic tissue, is attached to the fascial formations that envelop the aorta and its main vessels, duodenum, lesser omentum and other adjacent organs, which makes the pancreas, especially its head and body, immobile. IN AND. Kochiashvili called this ligament his own ligament of the uncinate process (lig. processus uncinatiumproprium). In pancreatic surgery, the intersection of this ligament is called the key of the operation in pancreaticoduodenal resection.

All produced external secret is excreted into the lumen of the duodenum through the main duct (ductus pancreaticus Wirsungi). In 1779, Santorini described an additional, rather large pancreatic duct (ductus pancreaticus accessorius). It is interesting that the possible formation of stones in it is not taken into account.

The location of these ducts is shown in Fig. 6 and 7. The main duct runs closer to the posterior surface of the pancreas. In very rare cases, the duct can pass outside the gland and has, as it were, its own mesentery (Fig. 8).

Rice. 6. Scheme of the location of the excretory main ducts of the pancreas: 1 - lumen of the duodenum; 2 - main virsunt duct; 3 - additional duct of Santorini; 4 - small ducts (interlobar), flowing into the main ducts

Rice. 7. Location of the Wirsung duct in the pancreatic tissue: a - typical: 6 - atypical with the location of the duct along the upper edge of the pancreas; c - atypical with the location of the duct along the lower edge; 1 - head of the pancreas; 2 - Wirsung duct; 3 - isthmus; 4 - body; 5 - tail of the pancreas

Rice. 8. Location of the Wirsung duct in relation to the body of the pancreas:
a - normal; b - along the posterior surface of the gland; in - behind the gland and outside it

Duodenum tightly fixed to the head of the pancreas, especially in the region of the large and small duodenal nipples. The lower horizontal part of the duodenum has its own fascial case, located in loose retroperitoneal tissue between the root of the mesentery and the posterior abdominal wall (V.I. Onupriev, S.E. Voskonyan, A.I. Artemiev, 2006). The cicatricial bands that connect these formations have to be crossed when the head of the pancreas is exposed. In the region of the head, the branches of the anterior and posterior pancreatoduodenal arteries (upper and lower) are quite pronounced and closely spaced from each other (Fig. 9).

Rice. 9. Blood supply to the head of the pancreas (scheme):
1 - duodenum; 2 - own artery of the liver; 3 - gastroduodenal artery; 4 - upper pancreatoduodenal artery; 5 - anterior branches of the superior pancreatoduodenal artery; 6 - head of the pancreas; 7 - anterior branches of the inferior pancreatoduodenal artery; 8 - lower pancreatoduodenal artery; 9 - superior mesenteric artery; 10 - posterior branches of the inferior pancreatoduodenal artery; 11 - posterior branches of the superior pancreatoduodenal artery; 12 - upper pancreatoduodenal artery; 13 - upper pancreatic artery; 14 - right gastroepiploic artery

The blood supply to the pancreas is complex and plentiful. It is carried out from two arterial systems: the celiac artery and the superior mesenteric artery. Two trunks depart from the celiac artery: the common hepatic artery, which passes into its own hepatic, and the splenic. The general scheme of blood supply to the pancreas is shown in Fig. 10, 11 and 12. These two systems anastomose well among themselves with large branches of arteries passing both inside the gland and along its surface. The ligation of these arteries practically does not lead to disruption of the blood supply.

Rice. 10. Scheme of blood supply to the pancreas:
1-a. coelica; 2-a. lienals; 3-a. pancreatica dorsatis; 4-a. pancreatic magna; 5 - a.a. pancreatica candalis; 6-a. pancreatica inferior; 7-a. mesenterica superior, 8 - a. pancreaticoduodenalis inferior; 9-a. pancreaticoduodenalis superior; 10-a. pancreatic superior; 11-a. gastricoepiploica dextra; 12-a. gastroduodenalis; 13-a. hepatica propria; 14-a. gastric sin

Rice. 11. Variants of the splenic arteries and veins in relation to the upper edge of the pancreas (front view):
1 - arteries; 2 - veins; 3 - pancreas (body, tail)

Rice. 12. Arterial blood supply of the pancreas (general scheme):
1 - right, left and common hepatic ducts; 2 - bile cystic duct; 3 - hepatic artery; 4 - gastroduodenal artery; 5 - anterior pancreatoduodenal artery; 6 - superior mesenteric vein and artery; 7 - splenic artery; 8 - aorta; 9 - liver; 10 - spleen

However, a clear orientation in the topography of the blood supply plays importance in pancreatic surgery. Damage to even one of them leads to difficult-to-control bleeding, especially when performing pancreatoduodenal resection. The splenic and superior mesenteric arteries in angiography are considered as central to the blood supply to the gland.

However, their ligation is not unambiguous in terms of outcomes. The splenic artery can be ligated even at the mouth, and a pronounced circulatory disorder does not occur either in the pancreas or in the spleen due to good collateral blood flow. This technique is often used to reduce portal pressure to prevent or treat bleeding from esophageal varices in portal hypertension. A positive effect is noted in 30% of cases, but it is temporary.

Ligation of the superior mesenteric artery leads to necrosis of the small intestine due to a lack of blood supply. These features of the blood supply are always taken into account in the treatment of aneurysms of these two central arteries by their embolization. Carrying out the latter without taking into account these features can lead to disaster (see below). Correct interpretation angiograms of these arteries and their large branches determines the principle surgical treatment. He substantiates the possibility of using the embolization technique (selective, superselective or super-, superselective) or the impossibility of its implementation.

In addition to the above tight fixation of the duodenum to the head, the ligament of the uncinate process of the pancreas has a less pronounced ligamentous apparatus (Fig. 13). An important role is given to the hepatoduodenal ligament, in which the vascular complex and the extrahepatic bile ducts closely adjoin each other. An approximate knowledge of these ligaments facilitates the performance of a number of surgical interventions on the stomach, spleen and, of course, on the pancreas.

Rice. 13. Ligament apparatus of the pancreas: 1 - stomach; 2 - gastro-pancreatic ligament; 3 - pancreas-splenic ligament; 4 - spleen; 5 - mesentery of the pancreatic-colic ligament; 6 - transverse colon; 7 - own ligament of the uncinate process; 8 - intimate fusion of the head of the pancreas with the duodenum; 9 - pyloric-pancreatic ligament; 10 - pancreas

The intersection of the own ligament of the uncinate process after its selection from the nearby v. portae, the superior mesenteric artery, it is not without reason that in surgery it is called the most difficult stage of the operation on the pancreas, especially since the vascular elements of the ligament also pass behind the gland (Fig. 14). The gastro-pancreatic ligament starts from the cardia of the stomach and the lesser curvature. This ligament is quite powerful, containing the left gastric artery and the initial section of the common hepatic artery. Slightly to the right of the gastro-pancreatic ligament is the arterial celiac trunk.

Rice. 14. The relationship of the common bile duct and vessels behind the pancreas: 1 - gate of the spleen; 2 - splenic artery; 3 - splenic vein; 4 - duodenum; 5 - common bile duct; 6 - gallbladder; 7 - ampulla of the bile duct; 8 - Wirsung duct; 9 - pancreatic tissue; 10 - uncinate process of the head of the pancreas; 11 - portal vein; 12 - superior mesenteric artery

The pancreas-splenic ligament fixes the tail of the pancreas to the spleen. The splenic artery and vein pass through this ligament. Their location is different, although basically they pass along the upper edge of the pancreas. All arteries and veins anastomose well with each other. The pancreas, as it were, is located in an arteriovenous sponge. That is why, with minor damage to the pancreas (puncture, biopsy), bleeding almost always occurs, which is difficult to stop after being pressed with a tupfer, sometimes you have to suture. If this property is well expressed in a normal gland, then with chronic inflammation when cirrhosis of the gland progresses, its dissection is practically bloodless.

I.N. Grishin, V.N. Grits, S.N. Lagodich

Like any gland of mixed secretion, the pancreas has a special structure of the blood supply system.

That is why the supply of arterial blood is carried out at the expense of several arteries at once, such as:

The superior pancreatoduodenal artery, branches of the gastroduodenal artery (which are a tributary of the common hepatic artery) - feed the head of the pancreas from the anterior surface.
The inferior pancreatoduodenal artery originates from the superior mesenteric artery and supplies the posterior surface of the pancreatic head.
Branches of the splenic artery - supply blood and nutrients to the rest of the pancreas (body and tail).

The upper and lower pancreaticoduodenal arteries have another peculiar feature - this is the connection of blood vessels to each other and the formation, thus, of the anterior and posterior parts of the arterial arch. Such arcs, interconnected, are the main part for the continuous circular movement of blood in the arteries.

arteries

Arteries and arterial arches are located in the pancreas, both intersecting with each other and in parallel. For example, if you look at the anatomical location of the posterior arch on the head of the pancreas and the anterior, then you can make an interesting remark: the posterior is much closer to the middle than the anterior.

In addition, there are two more special forms location of arterial arches:

Loose form, characterized by a large number of arteries that form the arcs themselves;
The main form of the arrangement of arcs, which is formed after the process of merging two arteries.

Gastroduodenal artery

This small blood supply vessel, 20-40 mm long and 2.5-5 mm in diameter, in a huge number of cases has a discharge from the common hepatic artery.

The artery is also located behind the department that controls the flow of food directly into the stomach. In addition, it crosses the initial section of the intestine in various ways.

Abnormal vascular discharge

Due to the special location of the blood supply to the pancreas, the appearance of various anomalies and pathologies is not so frequent. However, their occurrence is of great interest to surgeons.

One of these rare and dangerous cases in which vascular damage is possible is the departure of the right hepatic from the gastroduodenal artery. Why is it so dangerous for a person?

As long as the patient does not require surgery, during which pancreatoduodenal resection is performed (the only available treatment for cancer of the head of the pancreas, the preampullary part of the bile duct, and also the duodenal nipple), this anomaly is not terrible for him. However, if this problem did affect the patient, then solving it turned out to be not such an easy task.

In some literature, you can find that medicine has found the answer to this question. For example, the method of autovenous shunting of the right hepatic blood vessel, which was performed up to the intersection of the gastroduodenal.

There is also a lot of similar information in other books. There was also such an unusual case when the main hepatic blood vessel was divided into 4 turns: the right and left hepatic, gastroduodenal, and also the right gastric arteries. Such situations are especially dangerous in case of damage, especially subjected to destruction - any lobar hepatic artery.

Drainage of blood from the pancreas

As you know, any organ enriched with venous vessels also has veins that create an outflow of blood. Venous outflow from the pancreas is carried out through the pancreatoduodenal veins, which flow into the splenic, as well as the inferior and superior mesenteric, and left gastric veins. Together, this forms one large vein - the portal vein, which then enters the liver.

Scheme of blood supply

Based on the diagram showing circulatory system pancreas, you can see that most of the veins are located in the tail. arterial blood from these vessels must necessarily enter the circulatory system using the portal vein.
There are also cases when the outflow of the pancreas can pass through the vessels described above. Such pathologies and diseases are extremely dangerous, because they are able to develop both pancreatic tail necrosis and pancreatitis.

In addition, such a condition can lead to a dangerous state of the blood supply to the pancreas. bad habit like drinking alcoholic beverages. Why is this happening?
This is because dangerous to health in general, “a remedy that helps get away from all problems,” can cause necrosis of pancreatic cells. Alcohol directly affects the narrowing of smaller vessels, which, because of this, cannot bring nutrients to the cells. In this regard, the cells starve from a lack of nutrients and die.

Among other things, alcohol consumed in in large numbers, can cause the deposition of salts in the tail of the pancreas. Things are even more unpleasant for women who drink alcohol, because all these unpleasant processes develop more rapidly in them than in men.

Video about the signs of diseases of the pancreas

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✪ Anatomy of the small intestine

✪ Duodenum: topography, structure, functions, blood supply, regional lymph nodes

✪ Duodenum: where is it, how it hurts, symptoms and treatment of the disease

✪ Inflammation of the duodenum: symptoms and treatment of the stomach

✪ anatomy of the stomach and duodenum

Subtitles

Functions

However, most often the upper part of the duodenum begins at the level of the XII thoracic-I lumbar vertebra, then the intestine goes from left to right (upper bend) and down to the III lumbar vertebra (descending part), after which it makes a lower bend and follows parallel to the upper part, but already from right to left (horizontal part) to the spinal column at the level of the II lumbar vertebra (ascending part).

The place of transition of the duodenum to the jejunum, flexura duodenojejunalis, is located to the left of the spine, corresponding to the body of the II lumbar vertebra.

syntopia

Top part The duodenum from above and in front is adjacent to the square lobe of the liver, as well as to the neck and body of the gallbladder. When the intestine is displaced to the left, its initial section comes into contact with the lower surface of the left lobe of the liver. Between the upper part of the duodenum and the gates of the liver is the hepatoduodenal ligament, at the base of which the common bile duct passes on the right, the common hepatic artery on the left, and the portal vein in the middle and somewhat deeper.

The posterior inferior semicircle of the wall of the upper part of the duodenum, in the place where it is not covered by the peritoneum, is in contact with the common bile duct, portal vein, gastroduodenal and superior posterior pancreaticoduodenal arteries. The lower semicircle of this part of the duodenum is adjacent to the head of the pancreas.

Holotopia and peritoneal coverage

Lies in regio hypochondriaca dextra.

The peritoneum covers the duodenum unevenly. Its upper part is devoid of peritoneal cover only in the region of the posterior lower semicircle of the intestinal wall, that is, in the place where the intestine comes into contact with the head of the pancreas, the portal vein, the common bile duct and the gastroduodenal artery. Therefore, we can assume that the initial section of the intestine is located mesoperitoneally. The same should be noted about the ascending part of the intestine. The descending and lower parts have a peritoneal cover only in front and therefore are located retroperitoneally.

In general, the duodenum is covered by the peritoneum extraperitoneally.

Vessels and nerves of the duodenum

blood supply

4 pancreaticoduodenal arteries:

The superior posterior pancreaticoduodenal artery arises from the origin of the gastroduodenal artery behind the superior part of the duodenum and travels to the posterior surface of the pancreas, spiraling around the common bile duct.
The superior anterior pancreaticoduodenal artery arises from the gastroduodenal artery at the lower semicircle of the upper duodenum and passes from top to bottom along the anterior surface of the pancreatic head or is located in the trough formed by the descending part of the duodenum and the head of the pancreas.
The inferior posterior and inferior anterior pancreaticoduodenal arteries arise from the superior mesenteric artery or from the first two jejunal arteries. More often they depart with a common trunk from the first jejunal artery or from the superior mesenteric artery, less often - independently from the first and second jejunal arteries. Sometimes they can arise from the initial section of the middle colon, splenic or celiac arteries.
The inferior posterior pancreaticoduodenal artery runs along the posterior surface of the head of the pancreas and anastomoses with the superior posterior artery, forming the posterior arterial arch.
The inferior anterior pancreaticoduodenal artery passes along the anterior surface of the head of the pancreas or in the groove formed by the head of the gland and the descending part of the duodenum and, connecting with the superior anterior artery, forms the anterior arterial arch.

Numerous branches extend from the anterior and posterior pancreaticoduodenal arches to the wall of the duodenum and to the head of the pancreas.

Venous outflow

It is carried out by the pancreatic-duodenal veins, which accompany the arteries of the same name, forming venous arches on the anterior and posterior surfaces of the head of the pancreas.

Lymph drainage

Lymphatic vessels that drain lymph from the duodenum are located on the anterior and posterior surfaces of the pancreatic head. There are anterior and posterior pancreaticoduodenal lymph nodes.

, and concentrated bile and pancreatic enzymes than the epithelium of the distal small intestine. The structure of the epithelium of the duodenum also differs from the structure of the epithelium of the stomach.
In the submucosa of the duodenum (especially in its upper half), there are duodenal (Brunner's) glands, similar in structure to the pyloric glands of the stomach.

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Celiac artery and its variability in sheep ABSTRACT DIS. ... CANDIDATE OF BIOLOGICAL SCIENCES

STAVROPOL AGRICULTURAL INSTITUTE

The anatomy of the celiac artery in sheep in the existing anatomical veterinary manuals is described by analogy with cattle. Such a statement, as our studies have shown, is not true, since the anatomy of the celiac artery in sheep has its own specific features.

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Preview: Celiac artery and its variability in sheep.pdf (0.0 Mb)

Target. To study the possibility of using regional intravascular therapy in patients with pancreatic necrosis with drugs that “unblock” microcirculation in pancreatic necrosis. Material and methods. 106 patients with pancreatic necrosis were examined. Group 1 included 71 patients: 20 (28%) had sterile pancreatic necrosis, 51 (72%) had an infected one. The 2nd group is represented by 23 patients who, in order to improve blood circulation in the pancreas and open microvasculature in complex treatment, long-term arterial infusion (DAI) into the celiac trunk of antiplatelet agents and antibiotics was used. Sterile pancreatic necrosis was detected in 9 (39%) patients, infected - in 14 (61%) patients. The 3rd group included 12 patients with pancreatic necrosis, who were more early dates PAI was performed using alprostadil in combination with antibiotics. Of these, 9 (75%) patients had sterile pancreatic necrosis, 3 (25%) had an infected one. PAI was performed selectively in the pancreatic artery. Results. In group 1, 47 (67%) patients were operated on. The duration of treatment was 35.8 ± 2.3 days, mortality was 16.9%. In group 2, 10 (43%) patients were operated on, the duration of treatment was 24.8 ± 3.6 days. There were no lethal outcomes. In the 3rd group open operations required only 2 (16.7%) patients. The duration of hospitalization was 23.6 ± 2.1 days. There were no lethal outcomes. Conclusion. The use of regional administration of alprostadil leads to an improvement in blood circulation in the pancreatic parenchyma with stimulation of delimitation processes in the form of the formation of early fluid accumulations with a decrease in retroperitoneal tissue infiltration and infection.

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A variant of mobilization of the pancreatoduodenal complex during pancreaticoduodenal resection, which refers to “no-touch” isolation, is presented. An analysis of the variants of mobilization that have appeared in the literature associated with the early isolation and transection of the arteries supplying the proximal part of the pancreas is presented. Literature analysis shows the promise of “no-touch” isolation to increase the radicalness of the operation

Crossing the upper and lower pancreas duodenal arteries. four.<...>We consider it necessary to first cross the stomach duodenal artery, as the main artery that feeds<...>artery and duodenal intestine 2 cm below the pylorus.<...>pancreas duodenal arteries.<...>upper pancreas duodenal arteries.

Purpose: to evaluate the value of low-dose CT with bolus contrast enhancement (CT angiography) in planning transarterial chemoembolization in malignant neoplasms of the liver and pancreas. Material and methods. In the period from 2011 to 2013 at the Federal State Budgetary Institution “Institute of Surgery. A.V. Vishnevsky” of the Ministry of Health of the Russian Federation, chemoembolization was performed in 33 patients. A total of 48 interventions were performed. In 30 (90.9%) patients with liver tumors, 45 (93.75%) surgeries were performed. In 3 (9.1%) patients with pancreatic cancer after cryodestruction - 3 (6.25%) operations according to the method of the Central Research Institute of Roentgen Radiology. A single intervention was performed in 21 (63.6%) patients, repeated in 10 (30.4%), 3 times in 1 (3.0%), 4 times in 1 (3.0%). All patients underwent CT angiography prior to chemoembolization using low-dose scanning protocols and interactive reconstruction algorithms. Results. In all cases, chemoembolization was performed in full, and a good angiographic result was achieved. CT angiography allows you to reliably display the collateral circulation in the basin of the superior mesenteric artery and celiac trunk, their occlusive-stenotic lesions, calculate the angle of departure of the celiac trunk from the aorta. A variant of the anatomy of the celiac-mesenteric basin, which is considered normal according to the N. Michels classification, was found in 16 (48.5%) patients. “Standard” chemoembolization due to anatomical features and concomitant occlusive-stenotic lesions of the celiac arteries was performed only in 16 (33.3%) cases. Conclusion. The use of low-dose CT angiography makes it possible to examine all the arteries of the celiac-mesenteric basin with minimal radiation exposure for the patient. The resulting images allow you to accurately represent the features and select best option surgical intervention, thereby reducing the time of surgical intervention, reduce radiation exposure to medical personnel.

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Hepatic artery aneurysms account for about 20% of all unpaired aneurysms. abdominal cavity. The leading positions in diagnostics belong to invasive celiacography and spiral computed tomography. With small aneurysms, as well as with their intrahepatic localization, endovascular treatment is indicated. With aneurysms of the own hepatic artery, as well as large aneurysms, surgical treatment is indicated.

Through the gastrocolic ligament, as well as elements of the liver duodenal ligaments opened tallow<...>from the level of gastrointestinal discharge duodenal arteries before the bifurcation of the RCA and LCA.<...>Aneurysm of the proper hepatic artery (white arrow) in the elements of the hepatic duodenal <...>arteries.<...>If the aneurysmal sac is located distal to the gastro duodenal arteries, as well as

No. 2 [Annals of Surgical Hepatology, 2017]

In 7 (33.3%) - gastrointestinal duodenal arteries, in 3 (14.3%) - gastro- duodenal arcs<...>arteries - in 10, superior mesenteric artery - in 4, pancreatic duodenal arteries - in 2.<...>upper pancreas duodenal artery, in 2 - jejunal artery, according to one observation -<...>The source of bleeding was the stump of the gastrointestinal tract. duodenal arteries (n = 1), splenic artery<...>and lower pancreas duodenal artery: stenting of the common hepatic artery performed in

Preview: Annals of Surgical Hepatology No. 2 2017.pdf (0.3 Mb)

No. 3 [Annals of Surgical Hepatology, 2014]

The journal is intended for a wide range of surgeons and doctors of related specialties, who, by the nature of their activities, are faced with surgical diseases of the liver, pancreas and bile ducts. The journal publishes customized summarizing articles on topical issues of surgical hepatology written by leading experts from the CIS countries and far abroad, review articles, original papers, individual "cases from practice", as well as articles containing data experimental studies. When selecting articles, the editorial board Special attention pays unification of the presentation of the material and the applied methods of statistical data processing, which is one of necessary conditions modern research. On the pages of the journal, discussions are held on the most unresolved issues of hepatobiliary surgery. During the discussions, many prominent specialists of the CIS countries express their opinion. The editorial board considers the discussions interesting and useful and plans to continue this practice. The journal publishes reports and resolutions of conferences and abstracts of articles from foreign journals. A wide range of issues covered, the depth and clarity of the presentation of the material make the journal attractive both for specialists with experience in hepatobiliary surgery and for beginners.

arteries of the stomach duodenal the artery originated from the left hepatic artery.<...> � duodenal arteries (Fig. 3, 4).<...>duodenal artery. 1 - gastro! duodenal arte!<...>duodenal arteries; 3 - the appearance of spleen!<...>pancreas duodenal arteries.

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INTRA-ORGANAL ARTERIAL LIVER VASCULARIZATION OF AGRICULTURAL AND SOME WILD ANIMALS ABSTRACT DIS. ... CANDIDATE OF BIOLOGICAL SCIENCES

M.: MOSCOW VETERINARY ACADEMY

We set ourselves the task of studying the main and additional ways of arterial blood supply to the liver.

into the common trunk of the gastrointestinal duodenal and right gastric arteries.<...>gastro- duodenal arteries.<...>Then the vessel continues further as a gastro- duodenal artery.<...>in the gastrointestinal duodenal, in the form of a bundle of arterial branches.<...>Then depart from it: gastrointestinal duodenal.and the right gastric artery. . "After that, the ongoing

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Surgery of the abdominal organs. T.I Topographic anatomy of the anterior wall of the abdomen and abdominal organs.

The manual presents patterns and basic information on topographic anatomy and surgical interventions on the anterior abdominal wall and abdominal organs, provided for by the program for students to master the block of the Federal State Educational Standard in the specialty General Medicine and Pediatrics, taking into account the relevant competencies. In preparing the presented textbook, many years of experience of its compilers in teaching the relevant section of the curriculum for students of the above specialties was used. For the second edition, the manual has been revised and supplemented with modern technologies used in surgery. It is intended for students of medical universities studying under the programs of the specialist in General Medicine and Pediatrics.

splenic artery; 9 splenic vein; 10 splenic artery; 11 top duodenal- pancreas<...>artery; 12 gastrointestinal duodenal artery; 13 portal vein; 14 right gastric artery;<...> duodenal the artery is considered one of the terminal arteries a. gastroduodenalis<...>hepatic and gastrointestinal duodenal arteries.<...>Upper anterior pancreas duodenal duodenal arteries

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Objective of the study: development of an effective X-ray endovascular method for the diagnosis and treatment of patients with acute severe pancreatitis, available for wide use in surgical hospitals. Material and methods. The experimental part of the study was performed on 11 non-fixed organocomplexes of the organs of the upper floor of the abdominal cavity. In the clinical part of the study, the results of examination and treatment of 93 patients with acute pancreatitis were used.

duodenal <...>Catheterization of the mouth of the splenic artery was performed on 3 organocomplexes.<...>pancreas head body tail Celiac trunk (n = 5) 19.6 ± 1.6 18.6 ± 2.07 15.2 ± 2.2 * Gastric duodenal <...>artery (n = 4) 24.0 ± 2.2 13.7 ± 1.2 * 2.0 ± 0.8 * Splenic artery (n = 3) 1.3 ± 0.5 * 6.3 ± 0, 5<...> duodenal

A clinical observation of long-term survival of a patient with pancreatic carcinoma (PJ) after a radical intervention complicated by total pancreatic necrosis is presented. AT postoperative period it took a long-term treatment of the patient in the intensive care unit and a number of emergency surgical interventions, including pancreatectomy. The patient was discharged on the 99th day after radical intervention. Currently, the duration of follow-up of the patient is 8 years, there are no signs of recurrence of the malignant disease. Clinical observation convincingly shows effectiveness radical operations for patients with pancreatic cancer, as well as the need for timely pancreatectomy in severe postoperative pancreatic necrosis

Neoplasm of the pancreas: a – arterial phase before gastric chemoembolization duodenal <...>arteries (arrow); b – arterial phase after gastro-intestinal chemoembolization duodenal arteries

No. 1 [Bulletin of surgery named after I.I. Grekov, 2010]

They came from the splenic artery in 15 (57.7%) cases, gastrointestinal duodenal artery or her<...>LA head of the pancreas, coming from the gastrointestinal duodenal arteries.<...>and pancreas duodenal arteries.<...>gastro- duodenal and pancreas duodenal arteries.<...>LA gastrointestinal duodenal arteries (black arrow). Rice. 9.

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Purpose of the study: to improve the results of treatment of patients with pancreatic diseases. Material and methods. From 2010 to 2014, 59 robot-assisted operations on the pancreas were performed: 30 distal resections, 12 pancreatoduodenal resections, including one pancreatoduodenectomy, 5 median resections, 12 tumor enucleations. There were 48 women (81.4%), men - 11 (19.6%). The mean age of the patients was 48.4 ± 14.5 years. Results. The duration of pancreatoduodenal resections was 463.1 ± 111.1 min, distal resections - 218.0 ± 68.2 min, midline resections - 253.0 ± 37.7 min, tumor enucleation - 150.0 ± 49.0 min. Postoperative complications developed in 24 (40.7%) patients: in 19 - external pancreatic fistula, in 3 - gastrostasis, in 2 - bleeding. There was 1 death after pancreatoduodenal resection. Conclusion. Indications for robot-assisted pancreatic surgery are T1–T2 malignant tumors, neuroendocrine tumors, benign tumors no larger than 5–6 cm. The use of a robotic complex does not allow avoiding specific postoperative complications characteristic of operations on the pancreas.

duodenal artery.<...>upper pancreas- duodenal the vein was clipped and transected.<...> <...> duodenal <...>The first step was to mobilize the head of the pancreas and duodenal intestines.

Surgical treatment of pancreatic calculosis remains one of the unresolved issues of pancreatology, since there is no consensus on the method and nature of the surgical intervention. The article emphasizes the relevance of this problem and contains an overview of the methods of surgical treatment of pancreatic calculosis.

In addition, resection of the pancreatic head with preservation duodenal intestines (operations of Beger, Ligidakis<...>S - stomach, D - duodenal intestine, P - pancreas, J - jejunum, F - end of the small intestine, open<...>They introduced into practice a modification of the pancreatic head resection with preservation duodenal intestines (ope<...>parenchyma; d – completion of virsungolithotomy – the primary suture of the pancreas was placed. 1 - upper anterior pancreas duodenal <...>duodenal artery, 3 - dissected parenchyma of the head

Endoscopic ultrasonography in diseases of the pancreas

Medicine DV

Tutorial devoted to endoscopic ultrasonography in the diagnosis of pancreatic diseases. The textbook was compiled according to the training programs for highly qualified personnel - residency programs in the specialty Endoscopy.

arteries branching from the stomach duodenal artery, which is a branch of the common hepatic artery<...>, also the anterior and posterior branches of the lower pancreatic duodenal artery, considered a branch of the superior<...>Branches of the common hepatic and gastrointestinal duodenal arteries, as well as the right gastroepiploic artery<...>artery, 4 - portal vein, 5 - choledochus, 6 - pancreatic duct, 7 - duodenal intestine.<...>artery 5.

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Operative and clinical surgery of the abdominal organs

Publishing House of the Far Eastern Federal University

The manual presents basic information on topographic anatomy and surgical interventions in the abdominal cavity in an accessible form. The textbook on the discipline "Operative and Clinical Surgery" was compiled in accordance with the requirements of the Federal State Educational Standard and is intended for students in higher education programs - specialist's programs, in the specialties "General Medicine", "Pediatrics".

pancreatic artery; 12 - gastro- duodenal artery; 13 - portal vein; 14 - right gastric<...>upper and two lower pancreas duodenal arteries.<...>Within the ligament, the baked artery usually gives off gastro- duodenal artery (a. gastroduodenalis<...>hepatic and gastrointestinal duodenal arteries.<...>Upper anterior pancreas duodenal artery branches off the gastrointestinal duodenal arteries

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Solid pseudopapillary tumor of the pancreas is a rare, well-differentiated malignant neoplasm, characterized by a relatively favorable clinical course. Most often it occurs in women 20-30 years old. A solid pseudopapillary tumor of the pancreas has no specific clinical manifestations. Radiation diagnostics (ultrasound, CT, MRI) determines the changes characteristic of this tumor, such as heterogeneity and hypovascularity, reflects the solid and cystic components of the neoplasm. Separate reports describe the extraorgan location of a solid pseudopapillary tumor of the pancreas. The main method of treatment is surgery. The extent of pancreatic resection depends on the location and size of the tumor. In the case of a malignant course of the disease, chemotherapy and radiation therapy should be discussed

arteries, celiac trunk and mesenteric lymph nodes.<...>Tumor invasion into adjacent structures: wall duodenal intestines, stomach, spleen, mesenteric<...>The tumor was surrounded by branches of the superior mesenteric artery.<...>papilla duodenal intestines.<...>artery, aorta and right external iliac artery.

No. 3 [Bulletin of Surgical Gastroenterology, 2009]

Scientific and practical medical journal. The journal is intended for the general surgical community and specialists in related fields.

The rules for embolization of false aneurysms of the splenic and gastrointestinal tract are described in detail. duodenal arteries<...>1), in 5 more cases - aneurysm of the gastrointestinal tract. duodenal arteries, as well as one observation<...>embolized in 4 cases, gastrointestinal duodenal artery also in 4.<...>risms of the artery of the head of the pancreas and the proper hepatic artery.<...>, in 5 - gastric duodenal artery, 1 - cystic artery, 1 - left hepatic artery

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No. 1 [Annals of Surgical Hepatology, 2011]

The journal is intended for a wide range of surgeons and physicians of related specialties who, by the nature of their activities, are faced with surgical diseases of the liver, pancreas and bile ducts. The journal publishes customized summarizing articles on topical issues of surgical hepatology written by leading experts from the CIS countries and far abroad, review articles, original papers, individual "cases from practice", as well as articles containing data from experimental studies. When selecting articles, the editorial board pays special attention to the unification of the presentation of the material and the applied methods of statistical data processing, which is one of the necessary conditions for modern research. On the pages of the journal, discussions are held on the most unresolved issues of hepatobiliary surgery. During the discussions, many prominent specialists of the CIS countries express their opinion. The editorial board considers the discussions interesting and useful and plans to continue this practice. The journal publishes reports and resolutions of conferences and abstracts of articles from foreign journals. A wide range of issues covered, the depth and clarity of the presentation of the material make the journal attractive both for specialists with experience in hepatobiliary surgery and for beginners.

Surgeons need to know the status of veins such as the gastrointestinal tract. duodenal artery, SMV, and<...>(VBA), pancreas, duodenal and gastrointestinal duodenal artery supplying the hepatic<...>in the absence of contact of the tumor with the SMA and the gastrointestinal duodenal artery.<...>through the lower pancreas duodenal and gastroduodenal arteries.<...>� The test should be performed with gastric clamping� duodenal arteries.

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September 6, 2016 marks the 90th anniversary of the birth of the doctor of medical sciences, professor, famous surgeon - a pioneer in the development of original methods and technical means for the surgical treatment of diseases of the liver, biliary tract and duodenum, military transfusiologist Sergei Dmitrievich Popov

original methods and technical means of surgical treatment of diseases of the liver, biliary tract and duodenal <...>Popov defended his Ph.D. thesis on the topic “The failure of cults duodenal guts after<...>ligation of the gastrointestinal duodenal arteries" and was promoted to Senior Resident and then Junior<...>inventions on the diagnosis and surgical treatment of diseases of the liver, biliary tract and duodenal

The first observation of a primary multiple tumor dates back to 1804 (K. Rokitanski), later data on multiple tumors are presented in 1847 by Regnault and in 1855 by Barth. The founder of the study of this pathology is considered to be T. Billroth, who in 1869 not only described the case of a primary multiple tumor, but also introduced the criteria for primary multiplicity of tumors. In Russia in 2011

A variant of the development of visceral arteries in the form of a branching of the common hepatic artery from the superior mesenteric artery was revealed.<...>arteries (see figure, e).<...>superior mesenteric artery.<...>AT typical place right gastric and gastrointestinal duodenal arteries.<...>The iliococonic artery was ligated at its origin from the superior mesenteric artery.

The article analyzes the results of treatment of 51 patients with arrosive pancreatogenic bleeding against the background of false aneurysms of the vessels of the hepatopancreatoduodenal zone. In 18 cases, various variants of distal resections of the pancreas, splenectomy were performed; 24 patients underwent pancreatoduodenal resections, extended in 2 cases to duodenopancreatectomy; 7 patients - duodeno-preserving variant of proximal resections of the pancreas. The main mechanisms of occurrence of false aneurysms have been studied. Individual determination of the volume of surgical correction with radical removal of the pathological focus made it possible to guarantee surgical hemostasis in all cases, to avoid relaparotomies and deaths.

of the celiac trunk come from the splenic artery in 50-65% of cases, the gastroduodenal artery in 20<...>-25%, pancreas- duodenal c - 10-15%, hepatic - in 5-10%, left gastric - in 2-5% of cases<...>(28), the most characteristic are extended destructions in the region of the posterior wall of the descending branch duodenal <...>and its branches, in 5 aneurysms originated from the lower pancreas duodenal arteries.<...>choledochodon Roux-enabled loop with resection of 2/3 of the stomach and part duodenal

Benign pancreatic tumors - limited surgical operations for cystic and neuroendocrine neoplasms - a review of surgical interventions [Electronic resource] / Beger, Prokopchuk, Egorov // Annals of Surgical Hepatology.- 2015 .- No. 2 .- P. 74-90 .- Access mode : https://site/efd/502237

Introduction. Benign tumors of the pancreas (PT) can include intraductal papillary mucinous tumors, mucinous cystic tumors, serous cystadenoma, solid pseudopapillary tumor and neuroendocrine tumors (NET), most often insulinomas. The evolution of such organ-sparing interventions as enucleation, central resection (CR) of the pancreas and duodenum-sparing total or partial resection of the pancreatic head (DSHRH) demonstrates their effectiveness in benign tumors of the pancreas Purpose. Assess the possibilities of surgical treatment benign tumors RV by local resection, based on existing indications for surgical treatment, analysis of early postoperative complications and long-term results. Results. Tumor enucleation is recommended for all overt neuroendocrine neoplasms up to 3 cm in size in the absence of contact with the pancreatic duct. This method has been used mainly in NET and less frequently in cystic tumors. About 20% of enucleations were performed with a minimally invasive approach. Severe surgical postoperative complications that required repeated interventions were noted in 11% of cases, pancreatic fistula - in 33% of cases, hospital mortality was less than 1%. The main advantages of enucleation are the low rate of postoperative complications and very low hospital mortality. Two thirds of CR were performed in patients with overt cystic tumors and 1/3 in patients with NET. The high frequency of pancreatic fistulas and severe postoperative complications is associated with the treatment of the proximal pancreatic stump. A hospital mortality rate of 0.8% is an advantage of this operation. DSHRPG in 50% of cases was used in the form of a total resection of the head with segmental resection of the peripapillary zone of the duodenum and the intrapancreatic part of the common bile duct. Two thirds of these patients had overt or asymptomatic cystic tumors and 10% had NETs. The main advantage of these operations compared to pancreatoduodenal resection (PDR) is the preservation of exo- and endocrine functions to a greater extent and hospital mortality of less than 0.5%. The level of evidence for enucleations and CR is low due to retrospective evaluation of the data and lack of results from controlled studies. The benefits of DSPHP over PDR have been demonstrated by 9 prospective controlled trials, 3 case-control trials, and 2 retrospective controlled trials. Conclusion. When using enucleation, CR, total and partial DSHRPG, there is a low level of postoperative complications and very low hospital mortality. The main advantage of limited resections is the preservation of the exo- and endocrine functions of the pancreas and peripancreatic tissues.

observations was applied in the form of a total resection of the head with segmental resection of the peripapillary zone duodenal <...>Resection of the head of the pancreas with preservation duodenal intestines For the treatment of benign tumors<...>The technique of total DSHRPG with cutting off the head of the pancreas from the duodenum, while maintaining the posterior pancreas duodenal <...>arcade formed by the branches of the gastrointestinal duodenal arteries and lower pancreas duodenal <...>arteries, described in detail.

Creation of a reliable anastomosis after gastrectomy in both emergency and elective surgery peptic ulcer, remains one of the urgent problems . Despite the improvement of operational techniques, the use of modern technologies and various schemes of pharmacotherapy, the insolvency of the seams of the gastroduodenal anastomosis remains quite high and reaches 0.3-5%, with mortality from peritonitis up to 70%. Due to well-known circumstances, recently, intraoperatively, the surgeon is faced not only with an ulcerative locus, but also with severe ulcerogenic complications, which greatly complicates the operation, creates conditions for the development of postoperative complications, including suture failure.

arteries minimizes microcirculatory disorders of the proximal sections duodenal intestines, being<...>like in a wall duodenal intestines there is their close fusion.<...>New technologies in surgery of "difficult" ulcers duodenal intestines// Surgery. 2008. No. 8.<...>Basic principles of suturing on the stomach and duodenal intestine // Klin. hir. 1987. No. 8.<...>peptic ulcer surgery and duodenal intestines: A guide for physicians.

Purpose of the study: to demonstrate the possibilities of using transcatheter arterial embolization for bleeding from the upper gastrointestinal tract. Materials and methods: the results of the observation of 445 patients with acute gastrointestinal bleeding from the upper gastrointestinal tract from 2009 to 2014 are presented. Results: Changes in the surgical tactics for the treatment of gastrointestinal bleeding led to a decrease in postoperative mortality from 22.9% in 2009-2011 gg. up to 6.5% in 2012-2014 Conclusion: Transcatheter arterial embolization, due to minimal invasiveness, lack of anesthesia, laparotomy, efficacy and safety, and the possibility of repeat performance, especially in multimorbid and elderly patients, has shown to be effective in controlling bleeding and reducing mortality.

Bleeding into the lumen of the intrapancreatic cyst was in 3 patients and in 5 into the lumen duodenal <...>Endoscopy revealed a bleeding ulcer on the posterior wall of the bulb duodenal intestines. ForrestIA score<...>Performed angiography, celiacography, selective gastrointestinal catheterization duodenal arteries<...>patients with active bleeding (Forrest IA-IIB) from gastric ulcer and 10 patients with bleeding ulcer duodenal <...>Superselective catheterization of the splenic artery, occlusion of the artery with Gianturco coils Surgical

Modern resection surgery of the pancreas (PZ) is characterized by high dynamics of development. Along with the increase in radicalism and the expansion of the volume of operations in malignant tumors, there is also a desire to minimize operational trauma. This is represented not only in the change of operating access from open to laparoscopic, but also in the modification of direct operating techniques. Back in 1980, the German specialists H. Beger et al. for the treatment of chronic capitate pancreatitis, he proposed a technique for isolated resection of the pancreatic head, which allows preserving the integrity of the duodenum (duodenum).

pancreatitis proposed a technique for isolated resection of the head of the pancreas, allowing to preserve the integrity duodenal <...>Continuing the dissection along the gastrointestinal duodenal arteries downward, secrete its anterior branch.<...>distal CBD and major papilla duodenal intestines.<...>Dissect the structures of the hepatic duodenal Rice. 2.<...>arteries.

No. 4 [Annals of Surgical Hepatology, 2011]

(VBA) - lower pancreas duodenal arteries (Fig. 4).<...>Early ligation of the lower pancreas duodenal arteries (clamp attached).<...>Early ligation of the lower pancreas duodenal arteries using the anterior or mesenteric<...>In our practice, we use an anterior approach to the lower pancreas� duodenal arteries, counting<...>We believe that early ligation of the lower pancreas duodenal arteries not only allows

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TO THE QUESTION OF EMBRYOGENESIS AND BLOOD SUPPLY OF THE STASTROMA OF CATTLE ABSTRACT DIS. ... CANDIDATE OF BIOLOGICAL SCIENCES

OMSK STATE VETERINARY INSTITUTE

To study the following questions: 1. Specify by morphological studies the time of laying the multi-chamber stomach and the formation of its departments. 2. Find out if there are turns in the development of the multi-chamber stomach of cattle and what is their nature. 3. To study the formation of the arterial system of a multi-chamber stomach in the prefetal, fetal and alimentary periods of animal development. 4. To study the possible types of branching of the celiac artery, as well as the arteries extending from it, to systematize and try to explain the variants of branching of these arteries in cattle.

artery; . 6 - mesh artery; 7 - left common "gastric artery; 8 - left, gastric" artery; 9<...>from her arteries to the pancreas, special hepatic arteries, right gastric artery,<...>gallbladder artery, right gastroepiploic artery and cranial pancreas duodenal <...>arteries.<...>artery. eleven.

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No. 4 [Annals of Surgical Hepatology, 2018]

OPA depart gastrointestinal duodenal artery and left hepatic artery (LHA), from which<...>; from the APA depart gastrointestinal duodenal artery, own hepatic artery, depart from it<...>pancreas- duodenal artery (from it - PPA), gastroduodenal artery, artery of the IV segment<...>Arteries of the liver. 1 - celiac trunk, 2 - OPA, 3 - LVA, 4 - PPA, 5 - gastro- duodenal artery<...>Arteries of the liver. 1 - splenic artery, 2 - OPA, 3 - gastro- duodenal artery, 4 - artery

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No. 6 [Bulletin of Surgery named after I.I. Grekov, 2018]

Founded in 1885. Covers issues of clinical surgery, talks about the latest research, developments and technologies.

When the ulcer is located in duodenal hemostasis in the intestine was achieved by embolization of the gastroduodenal artery<...>arteries: 1 - common hepatic artery; 2 - gastro- duodenal artery; 3 - occluded<...>branch of the gastrointestinal duodenal arteries; 4 - own hepatic artery; 5 - catheter; b - after<...>segmental gastrointestinal embolization duodenal arteries: 1 - embolized section of the artery;<...>Performing TAE of the left gastric artery and its branches and gastro- duodenal arteries using

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COMPARATIVE-AGE MORPHOLOGY OF THE INTESTINE AND ITS BLOOD SUPPLY IN DOMESTIC DUCKS AND CHICKENS ABSTRACT DIS. ... CANDIDATE OF VETERINARY SCIENCES

M.: ORENBURG STATE AGRARIAN UNIVERSITY

Purpose of the study. To study the age-related morphology of the small and large intestines in a comparative aspect and to establish the features of their blood supply in Peking ducks of the Medeo cross and Loman white chickens.

Weight duodenal the guts of day old ducklings are 33.33% larger than those of pups (Tables 3 and 4).<...>blood supply to the caudal part duodenal and the initial part of the jejunum.<...>arteries) arteries. 3.<...>aorta and is involved in the blood supply duodenal, jejunum, ileum, blind and rectum.<...>duodenal intestine hepato-intestinal trunk and pancreas duodenal arteries (celiac)

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No. 3 [Annals of Surgical Hepatology, 2011]

artery, 2 - gastric duodenal artery, 3 - right hepatic artery, 4 - common bile<...>Isolation of the superior mesenteric artery in the retropancreatic region. one - duodenal intestine,<...>– displaced left VA, 4 – splenic artery, 5 – common VA, 6 – gastric duodenal artery<...>and gastrointestinal duodenal donor artery and bifurcation of the recipient's own VA.<...>artery, SA - splenic artery, IDA - gastric duodenal artery. _10_072-078_Rummo

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No. 4 [Annals of Surgical Hepatology, 2012]

In 5 (38.5%) - gastrointestinal duodenal arteries, in 2 (15.4%) - gastric duodenal arcs<...>After gastrointestinal embolization duodenal artery cyst festered, its drainage is under control<...>Embolization of the splenic artery was performed in 6 patients with gastrointestinal duodenal– 5, front<...>On the second day after the operation, bleeding from the gastrointestinal tract developed. duodenal arteries.<...>arteries.

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Target. To study variants of arterial blood supply to the liver according to angiography data and systematize them for performing X-ray endovascular interventions. Material and methods. Angiograms of 3756 patients were analyzed. Five types of blood supply have been identified depending on the “level of centralization” of hepatic blood flow. In each type, the variants are divided into groups according to the number of arteries supplying the right (V–VIII segments) and left (I–IV segments) functional lobes of the liver (Rx/Lx) separately. Results. 114 variants of blood supply were revealed. The central (general hepatic) type was observed in 68% of patients, it included 6 groups: the 1st group (50.8%) consisted of 10 variants of blood supply, the 2nd group (16.5%) - 5 variants, the 3rd group ( 0.6%) - 7 options, 4th group (

duodenal, total hepatic, village!<...>hepatic artery; LPA - left hepatic artery; MPA - middle hepatic artery; IDA - gastrointestinal<...>duodenal <...> <...>movable and fixed parts of the proximal third duodenal intestines. Wow!

#12 [Doctor, 2007]

Scientific-practical and journalistic journal for a wide range of specialists. Published since 1990. One of the most famous and prestigious publications for practicing doctors. The editor-in-chief of the journal is Academician of the Russian Academy of Medical Sciences I. N. Denisov. The editorial board of the journal includes recognized authorities in the world of medicine: N.A. E. M. Tareeva; V.P. Fisenko - Corresponding Member of the Russian Academy of Medical Sciences, (Deputy Editor-in-Chief) and many others. By the decision of the Plenum of the Higher Attestation Commission "Vrach" is included in the list of journals in which the publication of the results of dissertation research for the degree of Doctor of Science is recommended. Main sections: hot topic; clinical analysis; lecture; problem; new in medicine; pharmacology; healthcare. The release frequency is once a month. Target audience - attending physicians, chief physicians of hospitals and clinics, heads of medical institutions, heads of research institutes, medical centers, associations, heads of sanatoriums, pharmacies, libraries.

(MCA), anterior cerebral arteries (ACA), posterior cerebral arteries (PCA), vertebral arteries (VA) with<...>sites in the area of the stomach duodenal arteries (see Fig. 5, b) and SPA at the place of their division<...>After removing the clamps, pulsation of the stomach duodenal arteries, PA and shunt are distinct.<...>Operation stage: a - aneurysmal sac; b - gastrointestinal: duodenal artery; c - SPA Fig. 6<...>Stage of the operation: anastomosis is imposed between the gastro: duodenal artery and SPA Fig. 7.

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No. 2 [Annals of Surgical Hepatology, 2011]

major papilla duodenal guts L.M. guts<...>artery; perform arteriotomy; we introduce a port catheter into the lumen of the artery in the direction of the hepatic<...>arteries without leading into the lumen of the hepatic artery, we fix.<...>arteries from it as a separate trunk, contrasting volumetric formation of the pancreas.<...>pancreaticoduodenal arteries into the gastroduodenal artery, then into the parenchymal

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No. 3 [Annals of Surgical Hepatology, 2017]

grows into the wall of large arteries ( celiac trunk or superior mesenteric artery) Table 2.<...>The general hepatic and gastrointestinal duodenal arteries, the latter is crossed and tied.<...>intestine through the major papilla duodenal intestines.<...>Gastrointestinal duodenal the artery, spread out outside the conglomerate, is mobilized and ligated.<...>arteries and VV (n = 1).

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No. 1 [Annals of Surgical Hepatology, 2010]

mesenteric artery.<...>Gastric chemoembolization was performed. duodenal artery feeding the tumor, suspension 1000<...>arteries; splenic and hepatic arteries without signs of tumor invasion.<...>The introduction of oily chemosuspension into the gastric duodenal artery that feeds the tumor. _105-109<...>arteries; b – after embolization of the splenic artery trunk, extravasation is not determined, blood flow

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No. 4 [Annals of Surgical Hepatology, 2010]

ligaments with ligation of “non-target” arteries, gastric catheterization duodenal arteries (IDA) and<...>artery in 66 patients.<...>If there is difficulty in passing the catheter distal to the gastric duodenal her arteries were occluded<...>hepatic arteries from superior mesenteric, left gastric, gastric duodenal and celiac<...>One catheter was implanted into the stomach duodenal artery, the second - in the superior mesenteric vein

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No. 2 [Annals of Surgical Hepatology, 2009]

hepatic arteries or tumor-feeding arteries.<...>Gastrointestinal duodenal the artery is ligated and crossed.<...>Be sure to ligate with a preliminary intersection of the lower pancreas. duodenal artery<...>arteries anteriorly and to the left.<...>with areas of intact epithelium - a cyst in the wall duodenal intestines.

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No. 4 [Annals of Surgical Hepatology, 2017]

hepatic duodenal ligaments and along the common hepatic artery.<...>Clipped and transected gastrointestinal duodenal artery and common hepatic duct, its diameter<...> lymph nodes along the proximal section of the superior mesenteric artery and by clipping the inferior pancreatic duodenal <...>arteries.<...>It contains the lower pancreas duodenal artery, first jejunal artery and vein, lymphatic

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No. 2 [Annals of Surgical Hepatology, 2014]

duodenal, total hepatic, village!<...>duodenal artery; LVA - left gastric artery; SMA - superior mesenteric artery; * - blood supply<...>Mesenteric Mesenteric Aortic 2 arteries R1/L1 3 arteries 4 arteries 5 arteries 6 arteries R1<...>artery, 2 - lower anterior pancreas duodenal artery, 3 - dissected parenchyma of the head<...>duodenal ligaments: right in!

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#6 [Medical Imaging, 2018]

Aneurysms pulmonary artery. <...>and celiac trunk (CS) - up to 6 and 4%, respectively, in 3.5% of cases, the gastrointestinal duodenal <...>artery.<...>hamartochondroma) in the SIV of the right lung, post-inflammatory pneumofibrosis of the apex of both lungs, peptic ulcer duodenal <...>Radiation diagnosis and endovasal treatment of false aneurysms of the gastrointestinal tract duodenal duodenal, own, common hepatic artery and distal part of the celiac trunk<...>, in 1 - the common hepatic, in 12 - the splenic artery and in 1 - the lower pancreas duodenal <...>arteries.

Preview: Medical Imaging #2 2009.pdf (0.4 Mb)

No. 1 [Annals of Surgical Hepatology, 2019]

Scientific and practical publication covering the latest technology and equipment for obtaining and analyzing medical diagnostic images, methods for the clinical use of the entire arsenal of methods radiodiagnosis; considering medical and technical problems.

arteries (RCA) - in 3 (15%), all three main coronary arteries (LAD, LCx and RCA) - in 1 (5%)<...>arteries (RCA) - in 3 (15%), all three main coronary arteries (LAD, LCx and RCA) - in 1 (5%) case<...>The features of MRCP with pathological changes complex of the major duodenal papilla and duodenal <...>upper abdominal cavity (abdominal aorta, liver, spleen, stomach, pancreas, duodenal <...>The distribution of colored silicone in the pancreas when the solution is injected into the stomach duodenal

Preview: Medical Imaging #3 2014.pdf (0.7 Mb)

№1 [Practical oncology, 2009]

The journal covers the issues of epidemiology, etiology, diagnosis, prevention and treatment of some of the most common tumors. The authors are progressive oncologists who develop modern oncological science and have serious practical experience in the treatment of oncological diseases. Each issue of the journal covers a specific topic, on which both specialized articles and lectures, clinical observations and literature reviews in the field of scientific and practical research in clinical and experimental oncology are published, as well as materials of original papers containing the results of dissertations for the degree of doctor and candidate of medical sciences. Sciences

RIC SGSKhA

The textbook contains a description of the features of the topography of the organs of the lymphatic system of animals and birds. Questions concerning the features of branching of the nerves of the peripheral part are considered. nervous system, the course of blood vessels. Designed for teachers, full-time and part-time students of the Faculty of Biotechnology and veterinary medicine students in the specialty 36.05.01 "Veterinary".

propria) Gastrointestinal duodenal artery (a. gastroduodenalis) Splenic artery (a. lienalis<...>The celiac artery and its branches supply blood to the abdominal part of the esophagus, stomach, cranial area duodenal <...>They collect lymph from the proventriculus and abomasum of the stomach, spleen, duodenal intestines.<...>and duodenal intestines, and flows into the celiac nodes.<...> Small intestine presented duodenal, jejunum, ileum.

Preview: Anatomy of animals and birds (angiology, lymphatic system, neurology, ornithology) study guide.pdf (0.4 Mb)

No. 3 [Annals of Surgical Hepatology, 2015]

Antegrade balloon dilatation of the major papilla duodenal intestines with lithoextraction in duodenal <...>The common hepatic duct was crossed at the mouth of the cystic duct and the gastro- duodenal artery.<...>The right semicircle of the artery was dissected paraadventitially up to the first jejunal artery.<...>The latter was exposed to the mouth of the lower pancreas duodenal artery, which was clipped and re<...>in the hepatic artery - HVPA (n = 9)).

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