[Arterial variations and management strategies in pancreatic surgery].

Abstract

The pancreas is local in the retroperitoneal space,in close proximity to critical blood vessels such as celiac trunk, superior mesenteric artery, hepatic artery, splenic artery, and gastroduodenal artery. The high incidence of anatomical variations in these arteries significantly increases the complexity of pancreatic surgery. Such variations-particularly aberrant origins of the right hepatic artery, dorsal pancreatic artery, and gastroduodenal artery, as well as an anomalous course of the splenic artery,are strongly associated with complications such as intraoperative hemorrhage, positive resection margins, and hepatic ischemia. Currently, the clinical application of high-resolution computed tomography angiography, three-dimensional reconstruction, three-dimensional printing, and artificial intelligence-assisted imaging analysis has facilitated highly precise preoperative evaluation of these vascular networks. This review systematically summarizes the common arterial variations encountered during pancreatic surgery. By specifically analyzing the anatomical anomalies of the hepatic, dorsal pancreatic, inferior pancreaticoduodenal, gastroduodenal, and splenic arteries, corresponding surgical strategies are proposed to provide a practical reference for the safe and precise execution of pancreatic procedures.