Abstract
An 81-year-old man harbored a type 3 lesion that was detected from the mid-gastric curvature to the posterior wall on upper gastrointestinal endoscopy. Biopsy was performed, and he was diagnosed with highly to moderately differentiated adenocarcinoma. On contrast-enhanced computed tomography, lymph nodes #1 and #3 were highly enlarged, and there was an anomaly branch extending from the left gastric artery to the left head side, which flowed into the anterior descending coronary artery. For preoperative diagnosis of cT3N2M0 Stage IIIA advanced gastric cancer, we performed laparoscopic distal gastrectomy. Clamp forceps were used to block the blood flow of the left gastric artery, and he was then observed for 5 minutes using transesophageal echocardiography and 2-lead electrocardiograms during the surgery. After confirming that there was no ischemic change, the root of the left gastric artery was cut off, and the surgery was completed safely. The confluence between the left gastric artery and coronary artery is extremely rare. When cutting an artery that is in communication with the coronary artery, it is better to devise a novel surgical procedure.
