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The cystoduodenal ligament is also found in the lesser omentum and is distinct from both the hepatoduodenal and hepatogastric ligaments. The cystoduodenal ligament is an abnormal peritoneal fold that attaches the duodenum to the gallbladder , representing a rare variation in the anatomy of the lesser sac and its foramen.
The suspensory muscle of duodenum (also known as suspensory ligament of duodenum, Treitz's muscle or ligament of Treitz [1]) is a thin muscle connecting the junction between the duodenum and jejunum (the small intestine's first and second parts, respectively), as well as the duodenojejunal flexure to connective tissue surrounding the superior mesenteric and coeliac arteries.
The duodenal bulb is a remnant of the mesoduodenum, a mesentery that suspends the organ from the posterior abdominal wall in fetal life. [10] The first part of the duodenum is mobile, and connected to the liver by the hepatoduodenal ligament of the lesser omentum. The first part of the duodenum ends at the corner, the superior duodenal flexure.
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The Pringle manoeuvre is more effective in preventing blood loss during liver surgery if central venous pressure is maintained at 5 mmHg or lower. This is due to the fact that Pringle manoeuver technique aims at controlling the blood inflow into the liver, having no effect on the outflow. [3]
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By mobilizing the duodenum and pancreas, surgeons gain exposure to the structures in the hepatic portal area. Exposure of hepatoduodenal ligament: The procedure facilitates the dissection and exposure of the hepatoduodenal ligament. This exposure is crucial for various hepatic and biliary surgeries. Visualizing the common bile duct:
The gastroduodenal artery can be the source of a significant gastrointestinal bleed, which may arise as a complication of peptic ulcer disease.Because of its close relationship to the posteromedial wall of the second part of the duodenum, deeply penetrating ulcers or tumours of the duodenum may cause torrential bleeding from the gastroduodenal ‘artery of haemorrhage'. [1]