pancréas

Pancréas, the French term for the pancreas, is a gland located in the upper abdomen that functions as both an exocrine digestive organ and an endocrine gland. It lies retroperitoneally, with the head nestled in the duodenum, the neck anterior to major vessels, and the tail extending toward the spleen. The main pancreatic duct runs the length of the gland and typically joins the common bile duct to empty into the duodenum at the major duodenal papilla; many individuals also have a smaller accessory duct.

The exocrine pancreas consists of acinar cells that secrete digestive enzymes and ductal cells that produce bicarbonate-rich fluid. Pancreatic juice, containing amylase, lipase, and proteases (such as trypsinogen, chymotrypsinogen, and carboxypeptidases), is released into the duodenum to aid digestion. Secretin stimulates bicarbonate secretion, while cholecystokinin stimulates enzyme release, coordinating the neutralization of stomach acid and digestion of carbohydrates, fats, and proteins.

The endocrine component comprises the islets of Langerhans, which include alpha cells (glucagon), beta cells (insulin), delta cells (somatostatin), and pancreatic polypeptide–secreting cells. These hormones regulate glucose, lipid, and nutrient metabolism.

Vascular supply comes predominantly from the splenic artery and the superior mesenteric artery, with venous drainage to the portal system. Innervation is autonomic, modulating both exocrine secretion and endocrine release.

Clinical relevance includes acute and chronic pancreatitis, pancreatic cancer (notably pancreatic ductal adenocarcinoma), cystic fibrosis–related pancreatic insufficiency, and diabetes mellitus resulting from beta-cell dysfunction or loss. Understanding the pancreas requires recognizing its dual endocrine and exocrine roles and its integration into digestive and metabolic physiology.