For Treatment of the Lesser Curvature of the Stomach


The left gastric artery arises from the celiac artery and then divides into the upper and inferior branches, finally running into the gastric anterior and posterior walls. To perform the lymph node 3 dissection, the operator has to divide the vessels while recognizing this anatomy. Nearly 20% of patients have an accessory or aberrant left hepatic artery arising from the left gastric artery [1]. It usually runs into the left lobe through the gastrohepatic ligament. This vessel may supply most or all the arterial blood flow to the left lobe of the liver, in which case it has to be preserved to avoid liver abscess [2] (Fig. 7.1).


Vagus Nerve Left Lobe Laparoscopic Gastrectomy Celiac Artery Left Gastric Artery 
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  1. 1.
    Lurie AS (1987) The significance of the variant left accessory hepatic artery in surgery for proximal gastric cancer. Arch Surg 122:725–728PubMedCrossRefGoogle Scholar
  2. 2.
    Okano S, Sawai K, Taniguchi H et al (1993) Aberrant left hepatic artery arising from the left gastric artery and liver function after radical gastrectomy for gastric cancer. World J Surg 17:70–73PubMedCrossRefGoogle Scholar
  3. 3.
    Hiki N, Shimoyama S, Yamaguchi H et al (2006) Laparoscopy-assisted pylorus-preserving gastrectomy with quality controlled lymph node dissection in gastric cancer operation. J Am Coll Surg 203:162–169PubMedCrossRefGoogle Scholar
  4. 4.
    Jiang X, Hiki N, Nunobe S et al (2011) Long-term outcome and survival with laparoscopy-assisted pylorus-preserving gastrectomy for early gastric cancer. Surg Endosc 25:1182–1186PubMedCrossRefGoogle Scholar
  5. 5.
    Sakuramoto S, Yamashita K, Kikuchi S et al (2009) Clinical experience of laparoscopy-assisted proximal gastrectomy with Toupet-like partial fundoplication in early gastric cancer for preventing reflux esophagitis. J Am Coll Surg 209:344–351PubMedCrossRefGoogle Scholar
  6. 6.
    Sakuramoto S, Kikuchi S, Kuroyama S et al (2006) Laparoscopy-assisted distal gastrectomy for early gastric cancer: experience with 111 consecutive patients. Surg Endosc 20:55–60PubMedCrossRefGoogle Scholar
  7. 7.
    Ando H, Mochiki E, Ohno T et al (2008) Effect of distal subtotal gastrectomy with preservation of the celiac branch of the vagus nerve to gastrointestinal function: an experimental study in conscious dogs. Ann Surg 247:976–986PubMedCrossRefGoogle Scholar
  8. 8.
    Kinami S, Miwa K, Sato T et al (1997) Section of the vagal celiac branch in man reduces glucagon-stimulated insulin release. J Auton Nerv Syst 64:44–48PubMedCrossRefGoogle Scholar
  9. 9.
    Yamada H, Kojima K, Inokuchi M et al (2011) Efficacy of celiac branch preservation in Roux-en-Y reconstruction after laparoscopy-assisted distal gastrectomy. Surgery 149:22–28PubMedCrossRefGoogle Scholar
  10. 10.
    Shinohara T, Kanaya S, Yoshimura F et al (2011) A protective technique for retraction of the liver during laparoscopic gastrectomy for gastric adenocarcinoma: using a Penrose drain. J Gastrointest Surg 15(6):1043–1048PubMedCrossRefGoogle Scholar
  11. 11.
    Sakaguchi Y, Ikeda O, Toh Y et al (2008) New technique for the retraction of the liver in laparoscopic gastrectomy. Surg Endosc 22:2532–2534PubMedCrossRefGoogle Scholar

Copyright information

© Springer 2012

Authors and Affiliations

  • Shuji Takiguchi
    • 1
  • Yuichiro Doki
    • 1
  • Young Don Min
    • 2
  1. 1.Department of Gastroenterological SurgeryOsaka University Graduate School of MedicineSuitaJapan
  2. 2.Department of SurgeryChosun University College of MedicineDong-guRepublic of Korea

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