ANATOMY OF

HEPATOBILIARY AND
PANCREAS SYSTEM

KELOMPOK 3

ARIEF DWINANDA

YOHANES
 SYSTEMIC
REGIONAL ANATOMY ANATOMY

The digestive system

(gastroenterology) :
its associated organs
and glands that
function in ingestion,
mastication (chewing),
deglutition
(swallowing),
digestion, and
absorption of food
and the elimination of
the solid waste (feces)
remaining after the
nutrients have been
absorbed
 LIVER
The largest gland in the body, 1500 gr

All nutrients absorbed from the gastrointestinal

tract  liver by the portal venous system

Metabolic activities, Stores glycogen and

secretes bile
 SURFACE ANATOMY & PERITONEAL
REFLECTIONS, AND RELATIONSHIPS OF
LIVER
• FIXATION:
• OMENTUM MINUS
• LIG.GASTROHEPATICA
• LIG.HEPATODUODENALE
• LIG.FALCIFORME
• LIG TERES HEPATIS
• LIG.CORONARIUS ANTERIOR ET POSTERIOR
• LIG TRIANGULARE DEKSTRA ET SINISTRA
• LOBULASI
• 4 LOBUS : DEKSTRA, SINISTRA, CAUDATUS, DAN QUADRATUS.

• LETAK
• INTRAPERITONEAL, DILAPISI PERITONEUM (CAPSULA HEPATICA GLISSON), KECUALI BARE AREA
ANATOMICAL v
LOBES OF
LIVER
HEPATIC (SURGICAL)
SEGMENTS OF LIVER
The arterial supply  abdominal aorta  The hepatic portal vein  the superior
celiac trunk and the superior and inferior mesenteric + splenic veins  portal venous
mesenteric arteries system
LIVER BLOOD VESSEL
LIVER BLOOD VESSEL
LYMPHATIC DRAINAGE AND INNERVATION OF LIVER
HEPATIC PORTAL VEIN (HPV) AND
PORTAL–SYSTEMIC
ANASTOMOSES
Superior mesenteric + splenic vein HPV
(anterior to IVC & posterior to pancreas)

Collects blood with reduced oxygenation but

rich in nutrients from digestive system

Portal–systemic anastomoses  portal

venous system communicates with the
systemic venous system

Anastomoses  collateral circulation in cases

of obstruction in the liver or portal vein
 The peritoneum  continuous, glistening, and
PERITONEAL slippery transparent serous membrane 
mesothelium  simple squamous epithelial cells

1. The parietal peritoneum (internal

surface of the abdominopelvic wall)
• Same blood, lymphatic vasculature,
somatic nerve supply = region of the
wall it lines  sensitive to pressure,
pain, heat and cold, and laceration

2. The visceral peritoneum (invests

viscera)
• Same blood, lymphatic vasculature,
visceral nerve supply  stimulated by
stretching & chemical irritation 
referred to the dermatomes of the spinal
ganglia
Peritoneal Intraperitoneal organs  almost completely covered with visceral
peritoneum

Extraperitoneal, retroperitoneal, & subperitoneal  organs outside

the peritoneal cavity  partially covered with peritoneum  one
surface
Peritoneal cavity  potential space between parietal – visceral
layers  no organs  peritoneal fluid  lubrication + immune

Peritoneal fold  raised form the body wall by underlying blood

vessels, ducts, ligaments formed by obliterated fetal vessels

Peritoneal recess/fossa  pouch of peritoneum formed by

peritoneal fold
 Mesentery Omentum
• A double layer of • A double-layered
extension or fold of
peritoneum  a peritoneum  passes from
result of the the stomach and proximal
invagination of the part of the duodenum to
peritoneum by an adjacent organs in the
abdominal cavity
organ • The greater omentum 
• Neurovascular hangs down from greater
communications curvature of the stomach
and the proximal part of the
between the organ duodenum
and the body wall
• The lesser omentum 
• Ex : mesentery of connects the lesser curvature
the small intestine of the stomach and the
proximal part of the
duodenum to the liver
Peritoneal Ligament
• A double layer of
peritoneum that connects an
organ with another organ
or to the abdominal wall
• The liver =
• 1. Anterior abdominal wall
= falciform ligament
• 2. Stomach = hepatogastric
ligament
• 3. Duodenum =
hepatoduodenal ligament
(the portal triad)
• The stomach =
• 1. Diaphragm =
gastrophrenic ligament
• 2. Spleen = gastrosplenic
ligament
• 3. Transverse colon =
gastrocolic ligament
SUBDIVISIONS OF PERITONEAL CAVITY
 BILIARY DUCTS AND GALLBLADDER

Bile is produced continuously by the liver

 stored in the gallbladder  releases
 when fat enters the duodenum

The biliary ducts : bile from the liver 

duodenum
HEPATOCYTES  BILE  BILE CANALICULI  INTERLOBULAR BILIARY DUCT  COLLECTING BILE DUCT
(PORTAL TRIAD)  RIGHT/LEFT HEPATIC DUCT  COMMON HEPATIC DUCT  + CYCTIC DUCT  BILE
DUCT  DUODENUM
 GALLBLADDER

• Lies in the fossa for the gallbladder

on the visceral surface of the liver
• 3 parts : fundus, body, neck

• Arterial supply : cystic artery

• Venous drainage : cystic vein

Lymphatic drainage : to the hepatic

lymph nodes
 ARTERIES SUPPLYING THE BILE
DUCT & LYMPATIC DRAINAGE

Cystic artery  proximal part

Right hepatic artery middle part

Posterior superior pancreaticoduodenal artery &

gastroduodenal artery  retroduodenal part

The lymphatic vessels of the gallbladder and biliary

passages anastomose : superiorly  liver and
inferiorly  the pancreas  celiac lymph nodes
 NERVES AND VEINS OF LIVER AND BILIARY
SYSTEM
The venous drainage from the proximal part
of the bile duct and the hepatic ducts =
enter the liver directly

The posterior superior pancreaticoduodenal

vein drains the distal part of the bile duct
 hepatic portal vein

The nerves to the gallbladder and cystic

duct  the celiac plexus (sympathetic and
visceral afferent fibers), the vagus nerve
(parasympathetic), and the right phrenic
nerve (somatic afferent fibers)
PANCREAS - ACCESSORY DIGESTIVE GLAND

An exocrine secretion (pancreatic juice  duodenum

through the main & accessory pancreatic ducts

Endocrine secretions (glucagon and insulin from the

pancreatic islets of Langerhans  the blood
Retroperitoneal,
transversely crossing the
bodies of the L1 and L2
vertebra on the posterior
abdominal wall

4 parts :
1. Head - embraced by the C-
shaped curve of the duodenum
2. Neck - overlies the SMA
3. Body - to the left of the SMA
above the transpyloric plane
posterior to the omental bursa
4. Tail - anterior to the left kidney
ARTERIAL SUPPLY AND VENOUS DRAINAGE OF PANCREAS
 LYMPHATIC DRAINAGE AND
INNERVATION OF PANCREAS AND
SPLEEN

The pancreatic lymphatic vessels follow

the blood vessels

End in the pancreaticosplenic lymph nodes,

pyloric lymph nodes, superior mesenteric
lymph nodes, or celiac lymph nodes

The nerves of the pancreas  vagus and

abdominopelvic splanchnic nerves passing
through the diaphragm
HATUR NUHUN