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Review
. 2024 Apr;17(2):e13299.
doi: 10.1111/ases.13299.

Safe suprapancreatic lymph node dissection for gastric cancer with ectopic common hepatic artery

Kazuhiro Toyota  1 , Hayato Ishida  1 , Masayuki Mori  1 , Nobuyuki Okamoto  1 , Norimasa Kuraoka  1 , Raita Yano  1 , Hironori Kobayashi  1 , Yasushi Hashimoto  1 , Yoshihiro Sakashita  1 , Yujiro Yokoyama  1 , Yoshiaki Murakami  1 , Hiroshi Ishida  1 , Shinya Takahashi  2 , Katsunari Miyamoto  1
Affiliations
Review

Safe suprapancreatic lymph node dissection for gastric cancer with ectopic common hepatic artery

Kazuhiro Toyota et al. Asian J Endosc Surg. 2024 Apr.

Abstract

Suprapancreatic lymph node dissection for patients with gastric cancer in whom the common hepatic artery is located neither at the suprapancreatic margin nor in front of the portal vein is a more difficult procedure than when the common hepatic artery is in a more typical position. There is an increased risk of injury to the vessels that need to be preserved and inadequate lymph node dissection. Measures that have been reported for use in this situation are preoperative diagnosis with three-dimensional computed tomography angiography, dissection using the portal vain as a guide, and safe exposure of the portal vein with dissection to preserve the nerves at the suprapancreatic margin and in front of the portal vein. We review the literature and report our experience with a patient whose common hepatic artery was not located in the suprapancreatic margin who safely underwent suprapancreatic lymph node dissection using these methods.

Keywords: Adachi classification; common hepatic artery; gastric cancer.

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References

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