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十二指腸 및 膵臟의 動脈에 關한 硏究

Studies on the Arteries of the Duodenum and Pancreas.

최신의학 1965년 8권 12호 p.29 ~ 44
서상완,
소속 상세정보
서상완 (  ) - 서울대학교 의과대학 해부학교실

Abstract


This study of the pattern of arterial blood supply to the duodenum and pancreas and the statistical analysis of variants in this pattern was based on detailed dissection of 357 Korean fetuses aged from five to ten fetal months.
The results were as follows:
1. Posterior superior pancreaticoduodenal artery:
(1) Basic type: Arised from the gastroduodenal artery and anastomosed with the posterior inferior pancreaticoduodenal artery in 95.52%.
(2) Arised from the gastroduodenal artery and ended without anastomosis, the posterior pancreaticoduodenal arcade was lacking in one case (0.28%).

(3) Arised from the gastroduodenal artery and anastomosed with the anterior inferior pancreaticoduodenal artery in one case (0.28%).

(4) Arising from the gastroduodenal artery, divided into two branches, the outer branch anastomosed with the posterior inferior pancreaticoduodenal artery and the inner branch joined the anterior superior pancreaticoduodenal artery in on case (0.28%).
(5) Two origins, one from the gastroduodenal artery, the other from the superior mesenteric artery, joined to form one stem and anastomosed with the posterior inferior pancreaticoduodenal artery in one case (0-28%).
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(6) Arised from the superior mesenteric artery, and anastomosed with the posterior inferior pancreaticoduodenal artery in one case (0.28%).

(7) Arised from the proper hepatic artery and anastomosed with the posterior inferior pancreaticoduodenal artery in five cases (1.40%).

(8) Arised from the right hepatic artery and anastomosed with the posterior inferior pancreaticoduodenal artery in three cases (0.84%).

(9) Arised from the right gastric artery and anastomosed with the posterior inferior pancreaticoduodenal artery in one case (0.28%).

(10) Arised from the accessory right hepatic artery originated from the gastroduodenal artery and anastorr:-osed with the posterior inferior pancreaticoduodenal artery in one case (0.28%).
(11) Two origins, one from the gastroduodenal arter, the ether from the replaced right hepatic artery,
joined to form one stem and anastomosed with the posterior inferior pancreaticoduodenal artery in one case (0.28%).
(12) The origin of the posterior superior pancreaticoduodenal ´ artery was to the left of the common bile duct in 97.47%, anteriorly in 1.08% (3 cases), to the right in only 0.72% (2 cases) and to the both sides in 0.72%.
2. Supraduodenal artery:
The artery with the branch supplying the common bile duct in 91.73%, and the artery without the branch which supply the common bile duct in 5.40%, and the occurrence of this artery in 97.13%.
3. Retroduodenal artery:
The occurrence of this artery was in 94.24%.
4. Anterior superior pancreaticoduodenal artery:
(1) Basic type: Arised from the gastroduodenal artery and anastomosed with the anterior inferior pancreaticoduodenal artery in 93.84%.
(2) Arising from the gastroduodenal artery, divided into two branches, the outer branch anastomosed with the anterior inferior pancreaticoduodenal artery and the inner branch joined the upper part of the superior mesenteric artery in 2.52%.
(3) Arisnig from the gastroduodenal artery, divided into two branches, the outer branch anastomosed with the anterior inferior pancreaticoduodenal artery which arised from the right side of the first jejunal artery and the inner branch anastomosed with the second jejunal artery in 2.52%.
(4) Arising from the gastroduodenal artery, divided into two branches, the outer branch anastomosed with the anterior inferior pancreaticoduodenal artery and the inner branch anastomosed with the dorsal pancreatic artery in 1.12%.
(5) Arising from the gastroduodenal artery, divided into two branches, the outer branch anastomosed with the anterior inferior pancreaticoduodenal artery which was derived from the first jejunal artery and the inner branch joined the first jejunal artery in 0.28% (one case).
(6) Arising from the gastroduodenal artery, divided into two branches and the outer branch anastomosed
with the first jejunal artery and the inner branch joined the middle colic artery in 0.28% (one case).
(7) Arising from the gastroduodenal artery, divided into three branches, the outer branch was distributed
to the first and second part of the duodenum, the middle branch anastomosed with the anterior inferior
pancreaticoduodenal artery, and the inner branch joined the superior mesenteric artery in 0.28% (one case).
(8) Two arteries from the gastroduodenal artery joined to form one stem and anastomosed with the anterior
inferior pancreaticoduodenal artery in 0.56% (2 cases).
(9) Two arteries arised from the gastroduodenal artery and the pouter one anastomosed with the anterior inferior pancreaticoduodenal artery and the inner one joined the second jejunal artery on its right side in 0.28 % (one case).
(10) Arised from the right gastroepiploic artery and anastomosed with the anterior inferior pancreaticoduodenal artery in 0.28% (one case).
5. Inferior pancreaticoduodenal artery (anterior and posterior):
A. Common stem arising from:
(1) The right side of the superior mesenteric artery in 16.53%.
(2) The left side of the superior mesenteric artery in 15.69%.
(3) The posterior side of the superior mesenteric artery in 0.83%.
(4) The anterior side of the superior mesenteric artery in 0.28%.
(5) The right side of the first jejunal artery in 20.73%.
(6) The left side of the first jejunal artery in 8.96%.
(7) The posterior side of the first jejunal artery in 0.28 %.
(8) The second jejunal artery in 0.56%.
(9) The common hepatic artery in 0.28%.
(10) The right side of the replaced right hepatic artery derived from the superior mesenteric artery in 0.28%. B. Separate origins:
(11) From the right side of the superior mesenteric artery in 1.96%.
(12) From the left side of the superior mesenteric artery in 3.64%.
(13) The anterior inferior pancreaticoduodenal artery from the left side of the superior mesenteric artery and the posterior inferior pancreaticoduodenal artery from the right side of it in 0.56%.
(14) From the right side of the first jejunal artery in 11.20%.
(15) From the left side of the first jejunal artery in 3.92%.
(16) From the right side of the second jejunal artery in 0.28%.
(17) The anterior inferior pancreaticoduodenal artery from the right side of the first jejunal artery and the
posterior inferior pancreaticodudenal artery from the right side of the superior mesenteric artery in 6.72%.
(18) The anterior inferior pancreaticoduodenal artery from ;the left side of the first jejunal artery and the
posterior inferior pancreaticoduodenal artery from the left side of the superior mesenteric artery in 3.08%.
(19) The anterior inferior pancreaticoduodenal artery from the right side of the first jejunal artery
and the posterior inferior pancreaticoduodenal artery from the left side of the superior mesenteric artery in
0.56%.
(20) The anterior inferior pancreaticoduodenal artery from the left side of the superior mesenteric artery
and the posterior inferior pancreaticoduodenal artery from the left side of the first jejunal artery in 0.28%.
(21) The anterior inferior pancreaticoduodenal artery from the right side of the second jejunal artery and
the posterior inferior pancreaticoduodenal artery from the right side of the superior mesenteric artery in 0.28%.
(22) The anterior inferior pancreaticoduodenal artery from the left side of the first jejunal artery and the
posterior inferior pancreaticoduodenal artery from the right branch of the dorsal pancreatic artery in 0.28%.
(23) The anterior inferior pancreaticoduodenal artery ;from the left side of the first jejunal artery and the
posterior inferior pancreaticoduodenal artery from the replaced right hepatic artery derived from the superior
mesenteric artery in 1.12%.
(24) The anterior inferior pancreaticoduodenal artery from the right side of the second jejunal artery and the posterior inferior pancreaticoduodenal artery from the right side of the first jejunal artery in 0.56%.
(25) The anterior inferior pancreaticoduodenal artery from the first jejunal artery derived from the posterior inferior pancreaticoduodenal artery and the posterior inferior pancreaticoduodenal artery from the left side of the superior mesenteric artery in 0.28%.
(26) The anterior inferior pancreaticoduodenal arteries were two, one from the common stem and the other from the right side of the second jejunal artery and the posterior inferior pancreaticoduodenal artery from the common stem derived from the right side of the first jejunal artery in 0.56%.
(27) The anterior inferior pancreaticoduodenal artery from the right side ´of the first jejunal artery and the posterior inferior pancreaticoduodenal artery was lacked in 0.28%.
6. Prepancreatic arterial arcade:
(1) The branch of the anterior superior pancreaticoduodenal artery with the right branch of the dorsal pancreatic artery in 69.75%.
(2) The branch from the gastroduodenal artery with the right branch of the dorsal pancreatic artery in 14-01%.
(3) The branch of the right gastroepiploic artery with the right branch of the dorsal pancreatic artery in 5.32%.
(4) The absence of this arcade in 10.92%.
7. Dorsal pancreatic artery:
A. Origin from;
(1) The splenic artery in 29.13%.
(2) The celiac artery in 15-69%.
(3) The common hepatic artery in 13.17%.
(4) The superior mesenteric artery in 24.37%.
(5) The middle colic artery in 2.24%.
(6) The first jejunal artery in 1.12%.
(7) The middle colic artery derived from the replaced right hepatic artery came from the superior mesenteric artery in 0.28%.
(8) The middle colic artery derived from the common hepatic artery in 0.28%.
(9) The middle colic artery derived from the celiac artery in 0.28%.
(10) The accessory middle colic artery derived from the superior mesenteric artery in 0.84%.
(11) The accessory middle colic artery derived from the celiac artery in 0.28%.
(12) The replaced right hepatic artery came from the superior mesenteric artery in 0.84%.
(13) The gastroduodenal artery in 0.84%.
(14) The anterior inferior pancreaticoduodenal artery in 0.28%.
(15) The posterior inferior pancreaticoduodenal artery in 0.28%.
(16) The common stem of the middle colic and right colic arteries in 0.28%.
(17) Two origins, one from the common hepatic artery, the other from the celiac artery, joined to form one stem in 0.28%.
(18) The right and left branches arised from the splenic artery- separately in 0.28%.
(19) This artery was lacking in 9.24%.
B. Branches and anastomoses:
(1) Right branch --> anterior superior pancreaticcdt.cdenal artery, and left branch > inferior pancreatic artery in 66.670/,0´.
(2) Right branch --> gastroduodenal artery, and left branch > inferior pancreatic artery in 13.45%.
(3) Right branch right gastroepiploic artery, and left branch > inferior pancreatic artery in 5.32%.
(4) Right branch --> superior mesenteric artery, and left branch > inferior pancreatic artery in 0.28%.
(5) Right branch , anterior superior pancreaticoduodenal artery and left branch was distributed to the upper
border of the pancreas in 0.28%.
(6) Right branch anterior superior pancreaticoduodenal artery, and left branch divided into two branches. the large one was distributed to the upper border of the pancreas, the small one anastomosed with the inferior pancreatic artery in 0.28%,
(7) Right branch > gastroduodenal artery, and left branch was distributed to the upper margin of the pancreas in 0.28%.
(8) Right branch entered into the pancreas, and left branch --> inferior pancreatic artery in 0.280/0´.
(9) Right and left branch arised from the splenic artery separately and right branch > anterior superior pancreaticoduodenal artery, and left branch --> inferior pancreatic artery in 0.28%.
(10) Right branch > anterior superior pancreaticoduodenal artery, and left branch was lacking in 2.24% (11);Right branch -> gastroduodenal artery, and left branch was lacking in 0.28%.
(12) Right branch was lacking, and left branch > inferior pancreatic artery in 1.12%.
8. ` Pancreatica magna artery:
(1) Only one artery in 73.11%.
(2) Two arteries in 5.88%.
(3) Three arteries in 6.44%.
(4) Lacking in 14.57%.
9. Inferior pancreatic artery (origin):
(1) Left branch of the dorsal pancreatic artery in 86.83%.
(2) Terminal part of the dorsal pancreatic artery in 0.56%.
(3) Direct branch of - the splenic artery in 0.28 % .
(4) Continuation of the prepancreatic arterial arcade in 6.44 % .
(5) Direct branch of the gastroduodenal artery in 1.12%.
(6) Direct branch of the right gastroepiploic artery in 0.28%.
(7) Direct branch of the superior mesenteric artery in 0.28%.
(8) Lacking in 4.20%.
10. Caudal pancreatic artery (origin):
(1) Terminal branches of the splenic artery in 66-39%.
(2) Terminal part of the splenic artery in 8.40%.
(3) Terminal part of the splenic artery and the left gastroepiploic artery in 2.52%.
(4) Left gastroepiploic artery in 2.52%.
(5) Lacking in 20.17%.

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