ABSTRACT
The region of the duodenum and pancreas is an anatomically complex region (Fig. 28.1). A thorough understanding of this anatomy is essential due to the proximity of other organs, ducts and major vessels. The duodenum is arbitrarily divided into four portions beginning at the pylorus and ending at the ligament of Trietz. The majority of the duodenum is retroperitoneal, except for the first portion. The duodenum is fixed throughout most of its course, being adherent to the pancreas along its medial surface. The two ends of the duodenum are relatively mobile. The duodenum also lies directly over the lumbar portion of the vertebral column. A vast arcade of vessels supplies the duodenum and pancreas with multiple anastomoses.
