A Case of Laparoscopic-assisted Distal Gastrectomy in a Gastric Cancer Patient with a Vascular Anomaly

Abstract

A 37-year-old man presented to our hospital with vomiting and upper abdominal pain. Upper gastrointestinal endoscopy showed a 0-IIc lesion in the lesser curvature of the angler region, which was diagnosed as gastric cancer by a biopsy. Preoperative contrast-enhanced computed tomography (CT) scan showed a vascular anomaly of the celiac trunk. According to the Adachi classification, which classifies the patterns of branches of the celiac trunk into 28 groups with six types, his pattern was type VI. Type VI is a type in which the left gastric and splenic arteries form a common trunk, and which lacks a common hepatic artery. Accurate grasping of the vascular running pattern is essential for safe surgery. By sufficient preoperative imaging evaluation, we could perform laparoscopic surgery for gastric cancer with a rare vascular running pattern safely.