title: Usefulness of Preoperative Assessment of Perigastric Vascular Anatomy by Dynamic Computed Tomography for Laparoscopic Gastrectomy.
abstract: BACKGROUND
  Laparoscopic surgery requires a more detailed understanding of local anatomy than does conventional open surgery. The aim of this study was to examine the usefulness of dynamic computed tomography (D-CT) for identification of the location of the left gastric vein (LGV) and existence of the aberrant left hepatic artery (ALHA) compared with conventional enhanced computed tomography (E-CT).
  
  
  METHODS
  Sixty-eight patients underwent laparoscopic-assisted gastrectomy (LAG). E-CT and D-CT were performed in 32 and 36 patients, respectively, and three-dimensional computed tomographic angiography (3D-CTA) was performed in addition to D-CT. The location of the LGV and existence of the ALHA were confirmed during LAG, and these results were compared with those determined preoperatively by CT imaging.
  
  
  RESULTS
  The location of the LGV as detected by preoperative E-CT and D-CT was consistent with that identified during LAG in 28 (87.5%) and 31 (88.9%) patients, respectively, with no statistical differences. The existence of the ALHA as detected by preoperative E-CT and D-CT was consistent with that identified during gastrectomy in 24 (75%) and 36 (100%) patients, respectively, with a statistical difference (P = 0.005). Furthermore, the type of ALHA could be identified in 10 of 12 patients (83.3%) by D-CT.
  
  
  CONCLUSIONS
  D-CT can produce excellent images of the vascular supply, and thus undoubtedly contributes to the preoperative planning of LAG. Preoperative D-CT might be an informative tool with which to help overcome the disadvantages of LAG.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Osaki
authors.affiliation: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Saito
authors.affiliation: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Murakami
authors.affiliation: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.
authors.forename: Kozo
authors.initials: K
authors.lastname: Miyatani
authors.affiliation: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Kuroda
authors.affiliation: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Matsunaga
authors.affiliation: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.
authors.forename: Youji
authors.initials: Y
authors.lastname: Fukumoto
authors.affiliation: Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.
authors.forename: Masahide
authors.initials: M
authors.lastname: Ikeguchi
keywords: anatomy; computed tomography; gastrectomy; gastric cancer; laparoscopic surgery