In gastric tube reconstruction for esophagectomy, the blood flow to the gastric tube is mainly supplied by the gastroduodenal artery ( GDA ) via the right gastroepiploic artery ( RGEA ) . Ablation of RGEA in pylorus-preserving pancreaticoduodenectomy ( PPPD ) for pancreatic head cancer may cause ischemia of the gastric tube. The middle colic artery ( MCA ), splenic artery and jejunal artery are potential choices of donor vessel to reconstruct RGEA. We report a case of microsurgical reconstruction of RGEA with MCA, which was ligated during the operation for preservation of the gastric tube. The postoperative course was uneventful and the flow of RGEA was confirmed by CT angiography on the eighth postoperative day. It seemed reasonable to use MCA for the reconstruction of RGEA in that the positions of donor and recipient vessels are close and the sacrifice of blood flow to other organs is limited.
