The blood supply to the spleen comes from the splenic artery, a branch of the celiac trunk (variations in the celiac trunk pair the splenic with only one of the other vessels and rarely the splenic arises alone directly from the aorta). The splenic artery gives off significant branches to the body and tail of the pancreas. Ligation of the splenic artery in continuity to decrease bleeding risk and shrink a large spleen prior to mobilization must be done distally in order to minimize pancreatic devascularization. The splenic artery can be extremely tortuous. Terminal branching more commonly (2/3) starts a short distance from the hilum rather than in close. The left gastroepiploic artery is more often a branch of an inferior division than a direct branch from the splenic.
The splenic vein, the largest tributary of the portal system, lies below the artery in a groove behind the upper border of the pancreas. Multiple small branches drain the body and tail of the pancreas and the inferior mesenteric vein usually drains into the splenic beneath the body of the pancreas.
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