J Korean Gastric Cancer Assoc.  2007 Mar;7(1):42-46.

The Preservation of Left Gastric Atery in Laparoscopy-Assisted Subtotal Gastrectomy with Splenectomy of Stomach Cancer

• Lee SR
• Park JM
• Han SU
• Cho YK

Abstract

Usually in the subtotal gastrectomy, the left and the right gastric arteries, as well as the left and the right gastroepiploic arteries are ligated. Thus, to avoid a blue stomach surgeons preserve the spleen and the short gastric arteries. When a radical subtotal gastrectomy with splenectomy is performed, meticulous caution is necessary; otherwise, the subtotal gastrectomy might have to be changed to a total gastrectomy to prevent a blue stomach. We report the case of a 67-year-old woman who had distal stomach cancer with a splenic solitary mass, for which splenic meatastasis could be excluded. We planned and performed a laparoscopy-assisted radical subtotal gastrectomy with splenectomy as the diagnostic and therapeutic option. In this case, to avoid a remnant stomach infarction or total gastrectomy we saved the left gastric artery and vein with clearing perivascular soft tissue, lymphatics, and lymph nodes. Thus the radical therapeutic goal was reached, and serious complications were avoided.

Keyword

Laparoscopy-assisted subtotal gastrectomy; splenectomy; Left gastric artery; Infarction of remnant stomach

MeSH Terms

Aged
Arteries
Female
Gastrectomy*
Gastric Stump
Gastroepiploic Artery
Humans
Infarction
Lymph Nodes
Spleen
Splenectomy*
Stomach Neoplasms*
Stomach*
Veins