Multidetector computed tomography for preoperative identification of left gastric vein location in patients with gastric cancer.
BACKGROUND
The area near the left gastric vein (LGV) is a challenging site at which to perform dissection of the lymph nodes during gastrectomy. Therefore, knowledge of the precise location of the LGV is important. The objective of this study was to examine the usefulness of multidetector computed tomography (MDCT) for the identification of the LGV.


METHODS
Eighty-one patients with gastric cancer underwent MDCT, which was performed with contrast media in 76 patients and without contrast media in 5 patients. A 5-mm thin slice of the frontal image was reconstructed. These images were examined preoperatively to detect the location of the LGV. Upon gastrectomy, the LGV was identified and its location compared to that determined by MDCT.


RESULTS
The LGV was identified by MDCT in 76 of the 81 patients (93.8%). The LGV was subsequently located during the operation in all 81 patients. The LGV was located dorsal to the common hepatic artery in 40 patients (49.4%), ventral to the common hepatic artery in 18 patients (22.2%), ventral to the splenic artery in 17 patients (21.0%), dorsal to the splenic artery in 2 patients (2.5%) and in other positions in 4 patients (4.9%). In all patients, the location of the LGV detected using MDCT was consistent with that identified during gastrectomy. In the 4 patients with relatively unusual locations of the LGV, these 4 LGV variants were identified preoperatively by MDCT.


CONCLUSIONS
MDCT was useful for identifying the location of the LGV prior to gastrectomy.
Kawasaki
Kentaro
K
Division of Gastroenterological Surgery, Hyogo Cancer Center, Akashi, Hyogo, Japan.
Kanaji
Shingo
S
Kobayashi
Iwao
I
Fujita
Tadatoshi
T
Kominami
Hiroaki
H
Ueno
Kimihiko
K
Tsutida
Shinobu
S
Ohno
Masakazu
M
Ohsawa
Masato
M
Fujino
Yasuhiro
Y
Tominaga
Masahiro
M
Nakamura
Takeshi
T
D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008198:Lymph Nodes / Q000601:surgery; D010690:Phlebography / Q000379:methods; D011300:Preoperative Care; D013270:Stomach / Q000098:blood supply* / Q000000981:diagnostic imaging*; D013274:Stomach Neoplasms / Q000601:surgery*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014680:Veins / Q000601:surgery