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 2024/10/09 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.