Exploration of liver, gall bladder, pancreas, duodenum and spleen

General view of organs in situ, stomach elevated

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Image #145-4

Exploration of liver, gall bladder, pancreas, duodenum and spleen

General view of organs in situ, stomach elevated

The stomach has been elevated and pulled toward the right. The peritoneum has been removed from the omental bursa except in the area of the vestibule (4) to expose the left gastric artery (2) and splenic vessels (14,16) and structures associated with them. Peritoneum and connective tissue have been stripped from the pancreas.

1. Stomach (reflected)
2. Left gastric artery (exposed by dissecting gastropancreatic fold)
3. Liver (right lobe)
4. Upper pointer: Caudate lobe Lower pointer: Vestibule of omental bursa
5. Hepatic lymph node
6. Gastroduodenal artery
7. Upper pointer: Superior part of duodenum (elevated) Lower pointer: Descending part of duodenum
8. Upper pointer: Superior mesenteric vein (note pancreatic tributaries) Lower pointer: Superior mesenteric artery
9. Head of pancreas
10. Horizontal part of duodenum
11. Crus of diaphragm (covered by peritoneum)
12. Margin of peritoneum of gastrolienal ligament
13. Spleen
14. Branches of splenic artery
15. Filament of splenic plexus
16. Branch of splenic vein
17. Body of pancreas
18. Tail of pancreas
19. Left branch of middle colic artery
20. Jejunum (cut off close to duodenojejunal juncture)
21. Middle colic artery (origin from superior mesenteric artery not visible)
22. Kidney (covered by fascia)
23. Ascending part of duodenum
24. Superior mesenteric lymph node
25. Left colic artery
26. Inferior mesenteric artery