 So now let's take up the pancreas, which is the largest constituent of the bed of the stomach. My left hand is lifting up the stomach here and this structure that we see here in front of us, this is the pancreas. The pancreas has got the following parts. This portion is the head of the pancreas. This portion that we see here, this is the hook-like shape. This is called the unscenated process of the pancreas. There's a transient location between the head of the pancreas and the body of the pancreas where my instrument is located, that is referred to as the neck of the pancreas. Then we have the body and finally deep inside where my instrument is gone in, right near the region of the spleen is the tail of the pancreas. If you look at the location and the orientation of the pancreas, it is slightly obliquely transverse. The head and the unscenated process are located at the level of L3 and then the pancreas goes transversely up a little bit and the tail is located at the level of L1. So the location of the pancreas can be said to be from L1 to L3 in the retropadrenal space. So having mentioned these, let's mention a few important relationships. The head is completely enclosed within the C loop of the diodenum which we have cut open. So this is the superior part of the diodenum. This is the descending part of the diodenum. This is the transverse part of the diodenum and this is the ascending part of the diodenum. So within that is located the head of the pancreas and the unscenated process of the pancreas. Behind the neck of the pancreas is located the portal vein where my instrument is pointing and that is formed by the union of the superior miscentric vein and the splenic vein. So that is the relation of the neck of the pancreas. The body of the pancreas I told you forms the part of the bed of the stomach. Running behind the neck of the pancreas and partly behind the body of the pancreas we have the superior miscentric vein and the superior miscentric artery and they run behind and then they come in front of the unscenated process and then they run in front of the transverse part of the diodenum and in this place the superior miscentric artery may potentially compress the diodenum between the superior miscentric artery in front and the aorta behind. Running along the superior border of the pancreas is the highly tortuous splenic artery. The splenic artery is tortuous because it is located in the bed of the stomach and the stomach is constantly in motion as it is churning the food and therefore the splenic artery is tortuous to compensate for the movement of the stomach. Behind the pancreas and running in a groove on the posterior split of the pancreas we have the splenic vein and not forgetting that the posterior most relationship of the pancreas is the aorta and the inferior vena capable. And finally a very important relationship the tail of the pancreas where my instrument is pointing is located in this pleno renal ligament and it is in close contact with the hyalum of the spleen. So therefore whenever there is any injury or any surgery of the spleen the tail of the pancreas is likely to be injured. The tail of the pancreas is rich in islet cells of languid hands. So therefore when the tail of the pancreas is injured then the patient can get acquired diabetes. Now let me show you the opening of the main pancreatic duct into the second part of the diodenum. So we have already opened up the diodenum here and this is the where my instrument is going in. This is the opening or the papilla of batter which in this case is very enlarged and when I put my instrument in we can feel the tip of the instrument inside the main pancreatic duct of wits. Also opening here is the common bile duct. In some persons 1 cm similar to that there may be an opening again in the second part of the diodenum which is known as the accessory pancreatic duct or centaur knee duct which can have communication with the main pancreatic duct. Coming to the blood supply of the pancreas. The head and the arsenate process they are supplied by a branch of this artery here. This is the gastro-diodenal artery. The gastro-diodenal artery comes from the common hepatic artery and it runs behind the diodenum and it gives rise to a branch here which we can see this is the right gastro-diploid and it gives off another branch here. This is the superior pancreatic diodenal and the superior pancreatic diodenal divides into an anterior division and posterior division and we can see that here. So this supplies the head of the pancreas and the arsenate process and the diodenum from the top. Supplying the head of the pancreas and the arsenate process from below as well as the C loop of the diodenum from the inferior part we have this artery here. This is the inferior pancreatic diodenal artery which comes from the superior mesentery artery and that is accompanied by the inferior pancreatic diodenal vein here. So the inferior pancreatic diodenal artery in the vein they run from below up. They also divide into an anterior division and posterior division and they anastomers with the superior pancreatic diodenal artery and they form an anastomotic rk. So that supplies the head and the arsenate process of the pancreas as well as the C loop of the diodenum. In this correction we again have a very important surgical implication. Cancer of the head of the pancreas is not very uncommon. In which case when we have to do a surgery of the head of the pancreas we cannot remove the head of the pancreas separately. We have to do a pancreatic diodenectomy because of the commonality of the blood supply. We can have another cancer in the region of the head of the pancreas that is involving the region of the ampulla of batter and that is referred to as the periampullary carcinoma which is also a type of cancer of the head of the pancreas. Coming to the arterial supply of the body and the tail of the pancreas. The arterial supply is the splinic artery here. The splinic artery as I mentioned runs in a tortuous fashion along the superior border of the pancreas and that gives multiple pancreatic branches and two of those branches are name branches. One is known as the greater pancreatic branch and other is known as dorsal pancreatic branch and they supply the pancreas. So this is about the arterial supply of the head, body and the tail of the pancreas. The pancreas is prone to a condition known as pancreatitis. The most common cause of pancreatitis is biliary tract disease. The second most common cause of pancreatitis is alcoholism. As a sequel of pancreatitis one week or two weeks later fluid can collect in this place here which I mentioned and that collection is called pseudo pancreatic cyst. The pancreas is located in the retropytonial space. Therefore whenever there is pancreatitis pain is referred to the back and the patient prefers to sit leaning forward because that relieves the pain and because it is covered by loops of intestine in a normal situation, ultrasonic examination of the pancreas is not a very good method of examination. So therefore the ideal method of examination of the pancreas is by transverse CT scan of the abdomen or MRI. So this is a transverse CT scan of the abdomen and pancreas is denoted by the label number 4 and this is another CT scan where again the pancreas is shown by the label number 4 and under that is the static artery. So that is all for now about the pancreas. Thank you very much for watching. Dr. Sanjay Sanyal signing out. If you have any questions or comments please put them in the comment section below. Have a nice day.