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Japanese

A case of laparoscopic total gastrectomy in a patient with gastric cancer with a hepato-gastric trunk Ikumi HAMANO 1 , Yusuke MATSUMOTO 1 , Tetsuji NOBUHISA 1 , Masashi HASHIMOTO 1 , Kyohei KAI 1 , Shiso SATO 1 1Department of Surgery, Himeji Red Cross Hospital Keyword: 胃癌 , 腹腔鏡下胃全摘術 , 肝胃動脈幹 pp.561-566
Published Date 2016/9/15
DOI https://doi.org/10.11477/mf.4426200303
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 We report a case of early gastric cancer with a rare vascular anomaly of the hepato-gastric trunk, which can not be categorized by the Adachi classification system. A 64-year-old woman was referred to our hospital for gastric cancer treatment. Endoscopic examination revealed a 2-cm 0-IIc lesion in the lessor curvature of the upper gastric body. Preoperative multidetector row computed tomography showed the absence of the celiac artery, and the hepato-gastric trunk, splenic artery and supramesenteric artery were found to independently originate from the abdominal aorta. The hepato-gastric trunk ran upward and gave off the two left gastric arteries. Thereafter the hepato-gastric trunk passed downward along the attachment of the lessor omentum and gave off the left and right hepatic arteries. The common hepatic artery was not detectable at the superior border of the pancreas. 3D angiographic findings were identical to the intraoperative findings. Despite unusual patterns of vessel branching, preoperative diagnosis of the precise vascular anatomy could enable adequate lymph node dissection, thus maintaining blood flow to the liver.


Copyright © 2016, JAPAN SOCIETY FOR ENDOSCOPIC SURGERY All rights reserved.

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電子版ISSN 2186-6643 印刷版ISSN 1344-6703 日本内視鏡外科学会

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