Abstract
Background : The area above the pancreas is a challenging site at which to perform dissection of the lymph nodes during gastrectomy. Therefore, knowledge of the perigastric vessels is important. The objective of this study was to examine the usefulness of computed tomography (CT) for the identification of perigastric vessels. Methods : One hundred fourteen patients with gastric cancer underwent CT. A 5-mm-thin-slice frontal image was reconstructed. These images were examined preoperatively to detect anomalyies of the celiac artery, the existence of the accessory left hepatic artery (ALHA) and the location of the left gastric vein (LGV). During gastrectomy, the distribution of the perigastric vessels was compared with that of those suggested by the CT analysis. Results : Arterial anomalies were recognized in 7 preoperative cases. Defects in the common hepatic artery were found in 6 cases and the left gastric artery was directly divergent from the aorta in 1 case. Moreover, the ALHA was recognized in 7 cases. In all cases, the anomaly of the artery detected on CT was consistent with that identified during gastrectomy. The LGV was identified by CT in 102 of the 114 cases (89.4%). The accuracy rate was 94.7%. Conclusion : CT was useful for identifying the anomaly of the celiac artery and the location of the LGV prior to gastrectomy.
