title: Anatomical considerations of the infrapyloric artery and its associated lymph nodes during laparoscopic gastric cancer surgery.
abstract: BACKGROUND
  Little is known about the vascular and lymphatic distribution of the pyloric antrum in the stomach. We focused on the infrapyloric region containing the infrapyloric artery (IPA) and lymph nodes.
  
  
  METHODS
  The anatomy of the IPA and its associated lymph nodes was clinically elucidated during 156 laparoscopic gastrectomies.
  
  
  RESULTS
  Most of the arteries originated from the anterior superior pancreatoduodenal artery (ASPDA, 64.2 %) or the root of the right gastroepiploic artery (RGEA, 23.1 %), but a small portion originated from the gastroduodenal artery (GDA, 12.7 %). The average lengths from the pyloric ring to the IPA proximal branch were 21.8 mm from the ASPDA, 20.6 mm from the RGEA and 9.0 mm from the GDA, a significantly shorter length than the other 2 variations. On average, 2.5 out of 10.0 nodes existed along the IPA. One patient, whose tumor was located close to the pylorus, had a metastatic node in this section.
  
  
  CONCLUSIONS
  The IPA most commonly originates from the ASPDA and is associated with a certain number of lymph nodes. Vascular distribution from the IPA depends on the anatomic variation.
authors.affiliation: Department of Gastroenterological Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan.|Department of Surgery, Fujita Health University, Aichi, Japan.
authors.forename: Shusuke
authors.initials: S
authors.lastname: Haruta
authors.affiliation: Department of Gastroenterological Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan. shinohara@toranomon.gr.jp.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Shinohara
authors.affiliation: Department of Gastroenterological Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Ueno
authors.affiliation: Department of Gastroenterological Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan.
authors.forename: Harushi
authors.initials: H
authors.lastname: Udagawa
authors.affiliation: Department of Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Sakai
authors.affiliation: Department of Surgery, Fujita Health University, Aichi, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Uyama
mesh_terms: D001158:Arteries / Q000033:anatomy & histology*; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008197:Lymph Node Excision; D011708:Pylorus / Q000098:blood supply* / Q000601:surgery; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*
keywords: Gastric cancer; Infrapyloric artery; Laparoscopic surgery; Lymphadenectomy; Station no.6