A Case of a Gastric Cancer Patient with a Rare Vascular Anomaly that Cannot be Classified Based on Adachi's Classification

Abstract

We have experienced laparoscopic gastrectomy for an early gastric cancer patient with a rare vascular anomaly that cannot be classified based on Adachi's classification, that classifies the branching pattern of the celiac artery. The patient was a 63-year-old man. He presented with a 0-IIc lesion on the lesser curvature of the gastric angle by an esophagogastroduodenoscopy during a medical checkup. It was diagnosed as gastric cancer with a biopsy. Preoperative enhanced CT scan and 3D-CT angiography revealed such a vascular anomaly, as the splenic and the gastroduodenal arteries were branching from the superior mesenteric artery. At surgery, we performed laparoscopic distal gastrectomy with D1+ lymph node dissection and the vascular anomaly that was shown on the preoperative enhanced CT scan was confirmed during surgery. By understanding preoperative imaging features sufficiently, we could achieve a safe laparoscopic surgery even for a gastric cancer patient with a rare vascular anomaly.