Surgical anatomy of the innervation of pylorus in human and Suncus murinus, in relation to surgical technique for pylorus-preserving pancreaticoduodenectomy

Abstract

There are three routes of innervation of the pyloric region in humans, wherein the route of the right gastric artery is most important for preserving pyloric region innervation. Function will be preserved by more than 80% by preserving the artery in pylorus-preserving pancreaticoduodenectomy (PPPD). However, the route of the infrapyloric artery should not be disregarded. This route is related to several arteries (the right gastroepiploic and gastroduodenal arteries), and the preserving of these arteries is advantageous for preserving pyloric innervation in PPPD. Concurrently, the nerves of Latarjet also play an important role in maintaining innervation of the antro-pyloric region in PPPD. This is why pyloric function is not damaged in some patients when the right gastric artery is dissected or damaged in PPPD.

Surgical anatomy of innervation of the gallbladder in humans andSuncus murinuswith special reference to morphological understanding of gallstone formation after gastrectomy

“…Therefore, in the present study, the currently used gross anatomical dissection was not employed, but the effective method to label and dissect autonomic nerves of the viscera was employed, as in our previous studies [28][29][30][31] . We attempted to clarify the innervation of the GB in humans from a clinico-anatomical point of view, and to obtain a morphological understanding of gallstone formation after gastrectomy.…”

“…We attempted to clarify the innervation of the GB in humans from a clinico-anatomical point of view, and to obtain a morphological understanding of gallstone formation after gastrectomy. Furthermore, an experimental animal, Suncus murinus (S. murinus), has been shown to exhibit general morphological characteristics more similar to those of humans than other currently used laboratory animals, such as mouse, rat, rabbit [28,30,31] . Hence, this animal was employed for a comparative study to confirm our morphological observations in humans in the present study.…”

Innervation of Extrahepatic Biliary Tract, With Special Reference to the Direct Bidirectional Neural Connections of the Gall Bladder, Sphincter of Oddi and Duodenum inSuncus murinus, in Whole-Mount Immunohistochemical Study

“…The whole‐mount immunostaining procedures for S. murinus were performed as per our previous descriptions (Yi et al., , , ). Briefly, after rinsing in PBS, the fixed specimens were treated with 10 g/l periodic acid for 20 min to prevent any intrinsic peroxidase reaction.…”

“…The house musk shrew ( Suncus murinus ) is one of the most common insectivores; as an experimental animal, it has been shown to exhibit general morphological characteristics more similar to those of humans than other currently used laboratory animals, such as mouse, rat and rabbit. In our previous studies, the animal was employed for clinico‐anatomical and morphological studies of the innervations of the pancreas (Yi et al., ), major duodenal papilla (Yi et al., ), pylorus (Yi et al., ) and gall bladder (Yi et al., ), via comparative studies on humans.…”

Function-preserving surgery for gastric cancer

“…35 One is the superior region of the pylorus, which is related to the hepatoduodenal ligament, whereby the nerve branches arise from the anterior hepatic plexus containing the branches coming from the hepatic branch of the vagus. The nerves run along the right gastric artery, via the suprapyloric or supraduodenal branch, toward the antropyloric region (pyloric branch).…”