Surgical implications of the posterior gastric artery

The posterior gastric artery was identified during gastrectomy in 43 of 51 patients with distal gastric cancer. Two female patients had two posterior gastric arteries that originated separately from the splenic artery. Of these 45 arteries, 6 originated from the proximal third of the splenic artery, 35 from the mid third, and 4 from the distal third. These vessels coursed upward behind the posterior parietal peritoneum. The anterior and posterior walls of the remnant stomach were stained blue after injection of methylene blue solution into the splenic artery. The surgical importance of the posterior gastric artery is obvious because of its high frequency and deep origin and course. In addition, it is another source of blood supply to the stomach, and the lymphatics around this vessel form one of the primary routes draining the gastric fundus.