title: Strategic approach to concurrent aberrant left gastric vein and aberrant left hepatic artery in laparoscopic distal gastrectomy for early gastric cancer: A case report.
abstract: An aberrant left gastric vein (ALGV) directly entering the lateral segment of the liver is a rare variation in the portal vein system, whereas an aberrant left hepatic artery (ALHA) arising from the left gastric artery is observed relatively frequently. Here we report a case in which both ALGV and ALHA were encountered before laparoscopic distal gastrectomy with curative lymphadenectomy for gastric cancer. We accurately diagnosed these vessel anomalies preoperatively on abdominal contrast-enhanced CT. During surgery, we divided the ALGV at the point of entry to the liver and preserved the ALHA by dividing the branches toward the stomach, in consideration of curability and safety. The postoperative course was uneventful overall, although temporary mild liver dysfunction was observed. This case highlights the importance of preoperative evaluation and preparation in a rare case of concurrent ALGV and ALHA.
authors.affiliation: Department of Gastroenterological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Kuwada
authors.affiliation: Department of Gastroenterological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Kuroda
authors.affiliation: Department of Gastroenterological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Kikuchi
authors.affiliation: Department of Gastroenterological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Hori
authors.affiliation: Department of Gastroenterological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan.
authors.forename: Tetsushi
authors.initials: T
authors.lastname: Kubota
authors.affiliation: Department of Gastroenterological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Nishizaki
authors.affiliation: Department of Gastroenterological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Kagawa
authors.affiliation: Department of Gastroenterological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan.
authors.forename: Toshiyoshi
authors.initials: T
authors.lastname: Fujiwara
mesh_terms: D018279:Carcinoma, Signet Ring Cell / Q000601:surgery*; D005260:Female; D005743:Gastrectomy; D006499:Hepatic Artery / Q000002:abnormalities* / Q000601:surgery; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D011169:Portal Vein / Q000002:abnormalities* / Q000601:surgery; D013274:Stomach Neoplasms / Q000601:surgery*
keywords: Aberrant left gastric vein; aberrant left hepatic artery; laparoscopic gastrectomy