[Angiographic analysis of vascular anatomy in gastric cancer]

Celiac, left gastric, common hepatic and superior mesenteric angiography was performed in 296 gastric cancer patients. Relationship between anatomical variations and the mode of lymphatic metastasis was discussed. The emergence of right gastric artery was from hepatic artery proper in 46.9%, right, middle and left hepatic in 26.4%, common hepatic and gastroduodenal in 18.6%, and others in 5.4%. The rate of metastasis to suprapyloric nodes was the highest (20.0%) among the cases, in which the right gastric artery was given off distal to the hepatic artery proper. Left gastric artery emerged from the celiac in 94.9%, splenic in 2.7%, abdominal aorta in 2.1%, and common hepatic in 0.3%. Knowledge of the origin of the arteries is essential to thorough dissection of the perivascular lymph nodes. The accessory hepatic arteries emerged from left gastric artery in 17.9% of the cases, in which the rate of lymph node metastasis along left gastric artery was higher than others. Left gastric artery should be severed at its point of emergence for thorough dissection of lymph nodes along this artery in gastric cancer. However, the fact that 20.8% of accessory left hepatic arteries were perfusing more than 2 liver segments must be into consideration.