This lab teaches the structure of the upper abdomen including proximal and distal courses of the contents of hepatoduodenal ligament, celiac trunk, duodenum and pancreas.

1. Describe the hepatoduodenal ligament and its contents.
2. Describe the course of the bile duct from the liver to the duodenum.
3. Describe the relationship of the bile duct and the main pancreatic duct.
4. Describe the course and relations of the parts of the duodenum.
5. Name the branches and distribution of the celiac artery.
6. Describe the location and relationships of pancreas to duodenum, lesser peritoneal sac and spleen.
7. Describe the principal vessels ligated to remove the duodenum and head of the pancreas in a Whipple Procedure.

Upper Abdomen, Duodenum and Pancreas

Follow the proper hepatic artery proximally to identify the celiac trunk.

Locate the left gastric artery along the upper part of the lesser curvature of stomach and follow it to the celiac trunk.

Blunt dissect through the pancreas close to the celiac trunk to locate the tortuous splenic artery.

Identify the IVC above and below the diaphragm and note its close relationship to the caudate lobe of the liver. 

Place an instrument in the esophageal hiatus and divide the central tendon of the diaphragm.

Identify the esophagus, gastroesophageal junction and the stomach.

Identify the aortic hiatus with the diaphragmatic crura to either side. Note thoracic splanchnic nerves and celiac ganglia lateral to the crura.

Divide the aortic hiatus (crura) and locate the origin of the celiac artery from the aorta.

Incise the greater omentum along the greater curvature of the stomach in order to mobilize the stomach and expose the duodenum and pancreas.

Identify the pylorus, 1st, 2nd and 3rd parts of the duodenum and the head of the pancreas.  Examine the head, body and tail of the pancreas.

Identify the gastroduodenal artery as it branches from the common hepatic artery.

Re-identify the splenic artery and follow its course through the pancreas to the spleen. Note the splenic hilum and its close relationship to the tail of the pancreas.

Note the relationships of the spleen to 9th, 10th and 11th ribs on the left, and diaphragm, colon and kidney.

Re-identify the portal vein in the hepatoduodenal ligament.

Follow the portal vein inferiorly by incising the neck of the pancreas.

Reflect the head and body of the pancreas laterally to view the formation of the portal vein from the union of the splenic and superior mesenteric veins.