Sawano Takeyuki, Kimura Akitoshi, Shibata Saori, Yamamoto Takeshi, Yamauchi Yoichi, Kagiya Takuji, Ohashi Motonari, Kato Masashi, Hashimoto Naoki, Umehara Yutaka, Nishikawa Shinsuke, Murata Akihiko, Takahashi Kenichi
Dept. of Surgery, Clinical Oncology Center, Aomori Prefectural Central Hospital.
Gan To Kagaku Ryoho. 2020 Dec;47(13):2162-2164.
We report a case of successful laparoscopic distal gastrectomy for gastric cancer with an Adachi type Ⅵ group 24 vascular anomaly. A male in his 60s exhibited a type 0-Ⅱa plus Ⅱc lesion at the lesser curvature of the gastric angle by esophagogastroduodenoscopy and was diagnosed with tub2. He was referred to us for surgical treatment. The clinical diagnosis was cT1bN0M0, and cStage Ⅰ. Preoperative multidetector-row computed tomography(MDCT)showed an Adachi type Ⅵ group 24 vascular anomaly. At laparoscopic surgery, we dissected No. 8a lymph nodes with exposure of the surface of the portal vein because the common hepatic artery was absent. The left gastric artery and splenic artery formed a common trunk. As there are various kinds of vascular anomalies of the celiac artery branch, we must understand the arterial running pattern prior to gastric surgery. This technique is more useful in laparoscopic surgeries where tactile sensation is limited. To prevent perioperative and postoperative complications, we must recognize the anomaly pattern prior to surgery using MDCT.
