Blood supply to the duodenal papilla and the communicating artery between the anterior and posterior pancreaticoduodenal arterial arcades

The communicating artery (ComA) between the anterior and posterior pancreaticoduodenal arterial arcades is little understood, although it has been described several times during the past 100 years. In 44 of 51 cadaveric specimens in the present study, the typical ComA was observed to pass between the major and accessory pancreatic ducts. In addition, a second ComA was sometimes found crossing inferior to the major pancreatic duct. The typical ComAs often (36 of the 44) issued papillary branch(es). Although direct papillary branches of the posterior arcade were often observed to either coexist with (9 specimens) or exist independly (4 specimens), the ComA‐derived branch seemed to be critical for papillary blood supply, because of its shorter length, greater thickness, and higher frequency. Moreover, the typical ComA could be a good landmark during limited pancreatic resection, such as duodenum‐preserving subtotal resection of the pancreatic head or pancreatic segment resection, because the artery is likely to be an indicator of the borders between the celiac and superior mesenteric arterial territories, as well as those between the ventral and dorsal segments of the pancreas.