Computer-assisted three-dimensional reconstruction of the fetal pancreas including the supplying arteries according to immunohistochemistry of pancreatic polypeptide

Abstract

Purpose: Computer-assisted three-dimensional reconstruction of the fetal human pancreas was prepared to reconsider topographical relation between the dorsal/ventral anlagen and the vascular supply.

Methods: Tissue sections from the upper abdominal viscera of three fetuses were examined. Sections were immunohistochemically stained to determine pancreatic polypeptide expression, a marker of the ventral pancreas.

Results: The immunohistochemical findings were used to create three-dimensional computer-assisted reconstructions to identify pancreatic arteries. The narrowest part of the pancreas, or the neck, corresponding to a part of the dorsal pancreas, was located on the left side of the common bile duct, portal vein and gastroduodenal artery (GDA). The posterior arterial arcade accompanied the ventral pancreas, whereas the anterior arcade did not. In contrast to the GDA, the splenic artery was clearly separated from the neck in fetuses. The GDA appears to be the primary and stable arterial supply for the neck of the pancreas.

Conclusions: This observation may have implications for the preservation of the neck with the GDA during pancreaticoduodenectomy for benign and low-grade malignant diseases.

Fig. 1

Ventral 3D view of the fetal upper abdominal topographical anatomy. Upper abdominal organ sections of a CRL 155 mm fetus were used to create a 3D topographical reconstruction. The transverse line in a corresponds to the section shown in panel B (HE staining). Note the distinct neck of the developing pancreas (sandwiched by arrowheads). Adr adrenal glands, AO aorta, Duo duodenum, GB gall bladder, Kid kidneys, Panc pancreas, Sto stomach, UV umbilical vein

Fig. 2

Right-side view of a 3D reconstruction of the fetal ventral pancreas and pancreatic arteries. Upper abdominal organ sections of a CRL 155 mm fetus were immunochemically stained for pancreatic polypeptide (PP) expression (i.e., the ventral pancreas), and sections were then used to create a 3D topographical reconstruction. The blue color indicates strong PP expression. a The transverse line marked b–e correspond to the sections of immunostaining shown in b–e, respectively. Note the gastroduodenal artery (GDA) running alongside the neck of the pancreas (arrowhead). AIPDA and PIPDA anterior and posterior inferior pancreaticoduodenal artery, respectively; ASPDA and PSPDA anterior and posterior superior pancreaticoduodenal artery, respectively; CBD common bile duct, CT celiac trunk, D2 and D3 the second and third portions of the duodenum, SMA superior mesenteric artery. Other abbreviations are as for Fig. 1

Fig. 3

3D reconstructions of the fetal ventral pancreas and pancreatic arteries. Upper abdominal organ sections of a CRL 155 mm fetus were immunochemically stained for pancreatic polypeptide (PP) expression (i.e., the ventral pancreas), and sections were then used to create a 3D topographical reconstruction. a Ventral view. Note the gastroduodenal artery (GDA) crossing the neck of the pancreas after the origin of the posterior superior pancreaticoduodenal artery (PSPDA). b Dorsal view. Note the ventral pancreas occupies a large volume in the dorsal aspect of the pancreatic head. c Left-side view. The blue color indicates strong pancreatic polypeptide expression (i.e., the ventral pancreas). Other abbreviations are as for Figs. 1 and 2