title: Multidetector computed tomography for preoperative identification of left gastric vein location in patients with gastric cancer.
abstract: 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.
authors.affiliation: Division of Gastroenterological Surgery, Hyogo Cancer Center, Akashi, Hyogo, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kawasaki
authors.forename: Shingo
authors.initials: S
authors.lastname: Kanaji
authors.forename: Iwao
authors.initials: I
authors.lastname: Kobayashi
authors.forename: Tadatoshi
authors.initials: T
authors.lastname: Fujita
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kominami
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Ueno
authors.forename: Shinobu
authors.initials: S
authors.lastname: Tsutida
authors.forename: Masakazu
authors.initials: M
authors.lastname: Ohno
authors.forename: Masato
authors.initials: M
authors.lastname: Ohsawa
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fujino
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tominaga
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakamura
mesh_terms: 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