A Case of Laparoscopic Distal Gastrectomy for Gastric Cancer with an Adachi VI Type Vascular Anomaly

Abstract

A 61-year-old man was diagnosed with gastric cancer. Preoperative computed tomography showed a vascular anomaly of type VI in Adachi's classification. The patient underwent laparoscopic distal gastrectomy with D1+ lymph node dissection. The patient's postoperative course was uneventful, and the patient was discharged 11 days after surgery. In this case, the common hepatic artery couldn't be detected at the superior border of the pancreas, the left hepatic artery diverged from the left gastric artery and the right hepatic artery arose from the superior mesenteric artery. Since it was diagnosed as Adachi's type VI group 28. It was possible to perform laparoscopic surgery safely for gastric cancer with Adachi's type VI group 28 using the double-door opening style. It is important to understand the arterial running pattern before the operation.