The pancreas (plural pancreases, or pancreata) is an organ of the digestive system and endocrine system of vertebrates. In humans, it is located in the abdomen behind the stomach and functions as a gland. The pancreas is a mixed or heterocrine gland, i.e., it has both an endocrine and a digestive exocrine function. Ninety-nine percent of the pancreas is exocrine and one percent is endocrine. As an endocrine gland, it functions mostly to regulate blood sugar levels, secreting the hormones insulin, glucagon, somatostatin and pancreatic polypeptide. As a part of the digestive system, it functions as an exocrine gland secreting pancreatic juice into the duodenum through the pancreatic duct. This juice contains bicarbonate, which neutralizes acid entering the duodenum from the stomach, and digestive enzymes which break down carbohydrates, proteins, and fats in food entering the duodenum from the stomach. Inflammation of the pancreas is known as pancreatitis; common causes include chronic alcohol use and gallstones. Because of its role in the regulation of blood sugar, the pancreas is also a key organ in diabetes. Pancreatic cancer can arise following chronic pancreatitis or due to other reasons, and it carries a very poor prognosis, as it is often identified only after it has spread to other areas of the body. The word pancreas comes from the Greek πᾶν (pân, "all") & κρέας (kréas, "flesh"). The function of the pancreas in diabetes has been known since at least 1889, with its role in insulin production identified in 1921.
Structure
The pancreas is an organ that in humans lies in the abdomen, stretching from behind the stomach to the left upper abdomen near the spleen. In adults, it is about 12–15 centimetres (4.7–5.9 in) long, lobulated, and salmon-coloured in appearance. Anatomically, the pancreas is divided into a head, neck, body, and tail. The pancreas stretches from the inner curvature of the duodenum, where the head surrounds two blood vessels: the superior mesenteric artery and vein. The longest part of the pancreas, the body, stretches across behind the stomach, and the tail of the pancreas ends adjacent to the spleen. Two ducts, the main pancreatic duct and a smaller accessory pancreatic duct, run through the body of the pancreas. The main pancreatic duct joins with the common bile duct, forming a small balloon called the ampulla of Vater (hepatopancreatic ampulla). This ampulla is surrounded by a muscle, the sphincter of Oddi. This ampulla opens into the descending part of the duodenum. The opening of the common bile duct into main pancreatic duct is controlled by sphincter of Boyden. The accessory pancreatic duct opens into duodenum with separate openings located above the opening of the main pancreatic duct.
Parts The head of the pancreas sits within the curvature of the duodenum and wraps around the superior mesenteric artery and vein. To the right sits the descending part of the duodenum, and between these travel the superior and inferior pancreaticoduodenal arteries. Behind rest the inferior vena cava and the common bile duct. In front sit the peritoneal membrane and the transverse colon. A small uncinate process emerges from below the head, situated behind the superior mesenteric vein and sometimes artery. A pancreatic notch is a separation between the neck of the pancreas and the uncinate process. The neck of the pancreas separates the head of the pancreas, located in the curvature of the duodenum, from the body. The neck is about 2 cm (0.79 in) wide and sits in front of where the portal vein is formed. The neck lies mostly behind the pylorus of the stomach and is covered with peritoneum. The anterior superior pancreaticoduodenal artery travels in front of the neck of the pancreas. The body of the pancreas is the largest part of the pancreas and mostly lies behind the stomach, tapering along its length. The peritoneum sits on top of the body of the pancreas, and the transverse colon in front of the peritoneum. Behind the pancreas are several blood vessels, including the aorta, the splenic vein, and the left renal vein, as well as the beginning of the superior mesenteric artery. Below the body of the pancreas sits some of the small intestine, specifically the last part of the duodenum and the jejunum to which it connects, as well as the suspensory ligament of the duodenum, which falls between these two. In front of the pancreas sits the transverse colon. The pancreas narrows towards the tail of the pancreas, which sits near the spleen. It is usually between 1.3–3.5 cm (0.51–1.38 in) long and sits between the layers of the ligament between the spleen and the left kidney. The splenic artery and vein pass behind the body and tail of the pancreas.
Blood supply The pancreas has a rich blood supply, with vessels originating as branches of both the coeliac artery and superior mesenteric artery. The splenic artery, the largest branch of the celiac trunk, runs along the top of the pancreas and supplies the left part of the body and the tail of the pancreas through its pancreatic branches, the largest of which is called the greater pancreatic artery. The superior and inferior pancreaticoduodenal arteries run along the back and front surfaces of the head of the pancreas adjacent to the duodenum. These supply the head of the pancreas. These vessels join together (anastamose) in the middle. The body and neck of the pancreas drain into the splenic vein, which sits behind the pancreas. The head drains into, and wraps around, the superior mesenteric and portal veins, via the pancreaticoduodenal veins. The pancreas drains into lymphatic vessels that travel alongside its arteries, and it has a rich lymphatic supply. The lymphatic vessels of the body and tail drain into splenic lymph nodes, and eventually into lymph nodes that lie in front of the aorta, between the coeliac and superior mesenteric arteries. The lymphatic vessels of the head and neck drain into intermediate lymphatic vessels around the pancreaticoduodenal, mesenteric and hepatic arteries, and from there into the lymph nodes that lie in front of the aorta.
Microanatomy
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![Pancreas: An image using immunohistochemistry to show the location of different cell types in the pancreatic islet. Antibodies against glucagon (red-brown), secreted by alpha cells, show their peripheral position. Antibodies against insulin (blue), secreted by beta cells, show the more widespread and central position that these cells tend to have.[9]](https://upload.wikimedia.org/wikipedia/commons/thumb/0/05/Human_pancreatic_islet.jpg/1280px-Human_pancreatic_islet.jpg?utm_source=en.wikipedia.org&utm_campaign=parser&utm_content=thumbnail)

