Summary. The anatomy of the pancreatic veins has become the object of renewed interest due to the advent of pancreatic phlebography coupled with selective blood sampling to diagnose the site of endocrine tumors of this organ.This study, based on the examination of 50 postmortem glands prepared by the technique of injection-corrosion, was undertaken to identify the veins of the pancreas and establish anatomicosurgical correlations.The right pancreas is drained by four relatively constant veins of unequal importance. The two superior pancreaticoduodenal veins (posterosuperior and anterosuperior) join with the portal vein and gastrocolic venous trunk. Due to their large drainage territory these veins are the main routes of cephalic pancreatic venous return. The inferior pancreaticoduodenal veins (posteroinferior and anteroinferior) most often run into the jejunal veins and less frequently end in the superior mesenteric vein.A part of the right pancreas can be referred to as the retrovenous segment. Drainage of this territory is via the anteroinferior and both posterior pancreaticoduodenal veins as well as by one or two small veins (veins of the retrovenous pancreas) which merge with the posterior surface of the superior mesenteric vein.The left part of the pancreas is drained by numerous small venous tributaries of the vena lienalis. A second drainage axis, present in half of the cases studied, is the inferior pancreatic vein. The left gastric, inferior mesenteric and middle colic veins afford an accessory route of drainage of the left pancreas.The anatomical and surgical junction between the right and left parts of the pancreas can be referred to as the prevenous segment. The drainage of this segment is most often via the neighboring veins, although in some cases may be via true isthmic veins, which join the anterior surface of the mesentericoportal trunk.A protocol for the phlebographic exploration of the pancreas is proposed, based on these anatomical findings. Taking multiple selective samples of venous blood for hormone determinations should allow reduction of the error of tumor localization related to the rich network of venous anastomoses in the pancreas. Le drainage veineux du paner6as. Application ~ la phl6bographie pancr6atiqueR6sum& L'anatomie des veines du pancr6as b6n6fi-cie d'un regain d'int6r6t depuis que la phl6bogra-phie pancr6atique avec pr61~vements sanguins s6-lectifs est venue enrichir les moyens de localisation des tmneurs endocrines du pancr6as. Bas6e sur l'6-tude de 50 pi6ces d'injection-corrosion, leur description permet de retrouver la ~tualit6 anatomochirurgicale de la glande.Le pancr6as droit est drain6 par 4 veines relativement constantes mais dont l'importance est in6gale. Les veines pancr6atico-duod6nales sup~rieu-res (PDPS et PDAS) reioignent la veine porte et le syst~me du tronc gastrocolique; par l'6tendue de leur territoire de drainage, elles repr6sentent les p6dicules c6phaliques principaux. Les veines pancr6atico-duod6nales inf6rieures (PDPI et PDAI) gagnent le plus souvent les v...

A case of malignant islet-cell tumor with oncocytic features occurring in a 54-year-old woman with symptoms of organic hypoglycemia is reported. The tumor was composed of ribbons of cells arranged in an endocrine pattern. The cytoplasm of these cells was eosinophilic and finely granular. Ultrastructurally, the cells contained numerous mitochondria and dense-core neurosecretory granules. Tumor cells were focally immunoreactive for neuron-specific enolase, insulin, glucagon and VIP. Capillaries invasion and metastases to lymph nodes argued in favor of malignancy but there was no subsequent malignant involvement during a 3-year follow-up after surgery. Such insulinomas with oncocytic features have not been previously described. Endocrine features in oncocytomas of the pancreas and of other locations are discussed.

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