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Anatomic association between the gastrocolic trunk of Henle and right colic artery by high-quality CT venography

Xinzhe Zhao1,2,3, Hongda Zhang1,2,3, Hengyu Zhao1,2,3

  • 1Department of general surgery (intestinal surgery), The Sixth Affiliated Hospital, Sun Yat-Sen University, 26 Yuancun Erheng Rd, Guangzhou, 510655, Guangdong, People's Republic of China.

Scientific Reports
|December 31, 2024
PubMed

Insights

This study reveals new patterns in the gastrocolic trunk of Henle (GTH) anatomy using CT venography. Understanding these variations, particularly the colic tributary convergence, aids surgeons in radical right hemicolectomy.

Area of Science:

  • Surgical Anatomy
  • Vascular Anatomy
  • Colorectal Surgery

Background:

  • Mobilizing the right mesocolon and dissecting the gastrocolic trunk of Henle (GTH) are critical in hepatic flexure and transverse colon cancer surgeries.
  • Existing GTH tributary classifications lack practical guidance for radical right hemicolectomy due to anatomical acquisition challenges.

Purpose of the Study:

  • To analyze vessel associations of the GTH, including middle colic vein (MCV) convergence and right colic artery (RCA) presence.
  • To establish a novel classification of GTH anatomy based on colic tributary convergence relative to the anterior superior mesenteric artery and vein (ASMDV).

Main Methods:

  • Utilized ultra-thin CT for 3D reconstruction to analyze GTH anatomy in detail.
  • Categorized GTH variations into medial and lateral types based on colic tributary convergence point.
  • Assessed correlations between GTH types, RCA presence, and MCV convergence patterns.

Main Results:

  • Colic tributaries joined the GTH lateral to the ASMDV in 45.81% and medial in 54.19% of cases.
  • Right colic artery (RCA) presence showed a significant association with the lateral GTH type (p < 0.001).
  • Left-sided MCV convergence into the superior mesenteric vein (SMV) correlated with right colic vein presence (OR = 3.563, p = 0.007).

Conclusions:

  • A novel pattern of GTH variation, identified via high-level CT venography, significantly correlates with RCA presence.
  • This anatomical understanding assists surgeons in anticipating GTH variations during laparoscopic radical right hemicolectomy.

Keywords:
Anatomic variationCT venographyGastrocolic trunk of HenleMiddle colic vein

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