 Let us come to the pancreas. So, this is the pancreas where all the other organs have been removed. This is the head and this is the insinuate process of the pancreas. So, the head of the pancreas is this entire portion that we can see here. This is entire portion and it is encircled by the C loop of the teardrum, the superior descending horizontally and ascending part of the teardrum. This narrow portion that we see here, this is the neck of the pancreas. This entire portion is the body of the pancreas and this is the tail of the pancreas. The pancreas is roughly obliquely up in like this. Therefore, it extends from L3 to L1, vertebral levels. Now, let us come to the blood supply of the pancreas. So, as we mentioned this is the head of the pancreas and it is since this is the C loop of the teardrum. The blood supply is this artery that we see here. This is the superior pancritico-duodal artery which is the branch of the gastro-duodal artery. Other branch by the way is the right gastro-pecloid. The superior pancritico-duodal divides into an anterior and posterior division and it runs from above down inside the pancritico-duodal junction and going from below up we have this artery here. This is the inferior pancritico-duodal artery. This is the branch of the superior mesentric artery and we can see it is coming from the superior mesentric artery here and this goes in the pancritico-duodal junction from below up also dividing it into an anterior and posterior division and both these arteries and astromoes here. So, this supplies the head and the arsenate process of the pancreas because the blood supply of the head of the pancreas and the diodenum are closely interlinked. That is why there is when we are doing a special surgery that is a surgery for cancer of the head of the pancreas we cannot isolate the blood supply of the head of the pancreas separately and therefore we have to do what is known as the pancreatico-duodenectomy or Wipple's surgery. And while we are on this topic I would like to draw your attention though not directly relevant. This is the diodenum and this is the gyginum and we can see the cut into the gyginum here. At the diodenum-gyginal junction we have this fibromuscular structure which I have lifted up here this is that fibromuscular structure. This fibromuscular structure goes from the dj flexure and goes behind the pancreas as you can see it's going behind the pancreas and it gets attached to the right crust of the diaphragm. This is known as the suspense 3 ligament of treats and finally the blood supply of the rest of the pancreas that is the body and the tail it is supplied by the branches of the splinic artery which is shown here this is the splinic artery and that gives the greater and the dorsal pancreatic artery and many other armament branches. The important relations of the pancreas that is the most important thing I have already mentioned about the sea loop of the diodenum. The tail of the pancreas is related to the hylum of the spleen and it was located like this which we have removed. The vascular relations are even more important so let's take a quick look at the vascular relations. For that I have lifted up and we can see that this is the supramacentric artery and this is the supramacentric vein. The artery is to the left the vein is to the right. So these two structures they run especially the supramacentric vein runs behind the neck of the pancreas and the artery runs just behind the body of the pancreas that is one important relation. Behind the neck of the pancreas if I lift it up we can see that the supramacentric vein is uniting with the splinic vein to form the portal vein so this is the union. Supramacentric vein, splinic vein continuing as the portal vein and we can see the other part of the portal vein in the extrampatic portal triad. When I reflect like this we can see that this is the other part of the portal vein. So that is another important relationship. The next important relationship is the splinic vessels themselves. So for that if I were to put it back this is the normal relationship. The splinic artery runs along the upper border of the pancreas. So this is the splinic artery. In a normal situation the splinic artery will be much more torturous than this and the splinic vein runs behind the body of the pancreas and we can see a groove here. This groove is where the splinic vein was running so that is another important relationship. Artery on the upper border, vein behind the body of pancreas and finally if I were to remove all these structures we see the H3A vena cava, the left renal vein and the aorta. These are related posterior most relationships of the pancreas. So these are the entire vascular relationships of the pancreas. And finally coming to the tail of the pancreas. The tail of the pancreas is related to the hylum of the spleen. If there is an injury to the spleen or if there is any surgical intervention on the spleen the tail of the pancreas is quite likely to be injured and the tail of the pancreas is rich in allergenic langerhands and therefore the patient can have iotrogenic or patient doctor induced diabetes meritus. So that is about the pancreas. Now in this connection I need to tell you one very important clinical correlation. I have opened up the diurnal and you can see that this is the diurnal papilla and I have calculated it with my instrument here. This is the procedure that we adopt for what is known as endoscopic retrograde cholangio pancreatogram which not only shows the biliary treat but it also shows the pancreatic duct. So therefore it's a combined procedure for both pancreas and the pancreatic biliary part. This is a still short image of an ERCP showing the pancreatic biliary ductal system. We can have two types of cancer of the head of pancreas. One of them is a cancer of this region which I showed you a little while earlier namely the region around the ampoule of better. That is known as a periampullary carcinoma that means the cancer occurs in this region around the ampoule of better. That is called periampullary carcinoma and the other is cancer of the head of the pancreas which is not very uncommon. In any of these situations it is very obvious that it blocks the common bile duct and these patients have very severe jaundice and not only that the common bile duct becomes distended it becomes as big it can become even more than 1 centimeter in diameter that means more than 10 milliliters. In such cases what we do is we take this common bile duct and we anastomose it with the diodenum to relieve the jaundice and that is called kale doko diodenostomy and it is technically not very difficult because we know that the common bile duct is running right behind the diodenum. So, that is the procedure it is a palliative procedure it is not a curative one it just relieves the jaundice and the itching which comes with jaundice. I have already mentioned about the injury to the tail of the pancreas. Another important clinical correlation is alcoholic or any other pancreatitis. The pancreas forms an important constituent of the bed of the stomach. The stomach is located here. So, when the pancreatitis is resolving fluid from the pancreas can collect in this region here where my hand is located and that collection occurs in the lesser sac or the ovental person and that is called pseudo pancreatic cyst. So, 2-3 weeks after pancreatitis we can see a swelling here and that is collection in the lesser sac. So, that is a sequel of pancreatitis. That is all. You can switch off by pressing the black button.