RT Book, Section
A1 Ellison, E. Christopher
A1 Zollinger, Robert M.
SR Print(0)
ID 1127271588
T1 ARTERIAL BLOOD SUPPLY TO THE UPPER ABDOMINAL VISCERA
T2 Zollinger's Atlas of Surgical Operations, 10e
YR 2016
FD 2016
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-179755-9
LK accesssurgery.mhmedical.com/content.aspx?aid=1127271588
RD 2024/04/19
AB The  stomach  has  a  very  rich  anastomotic  blood  supply.  The  largest  blood  supply  comes  from  the  celiac  axis  (1)  by  way  of  the  left  gastric  artery  (2).  The  blood  supply  to  the  uppermost  portion,  including  the  lower  esophagus,  is  from  a  branch  of  the  left  inferior  phrenic  artery  (3).  The  left  gastric  artery  divides  as  it  reaches  the  lesser  curvature  just  below  the  esophagogastric  junction.  One  branch  descends  anteriorly  (2a)  and  the  other  branch  posteriorly  along  the  lesser  curvature.  There  is  a  bare  area  of  stomach  wall,  approximately  1  to  2  cm  wide,  between  these  two  vessels  which  is  not  covered  by  peritoneum.  It  is  necessary  to  ligate  the  left  gastric  artery  near  its  point  of  origin  above  the  superior  surface  of  the  pancreas  in  the  performance  of  a  total  gastrectomy.  This  also  applies  when  70%  or  more  of  the  stomach  is  to  be  removed.  Ligation  of  the  artery  in  this  area  is  commonly  done  in  the  performance  of  gastric  resection  for  malignancy  so  that  complete  removal  of  all  lymph  nodes  high  on  the  lesser  curvature  may  be  accomplished.