Left Gastric Vein On The Dorsal Side Of The Splenic Artery: A Clinical Anatomical Study

Objective The left gastric vein (LGV) is an important blood vesselrequiring dissection during gastric surgery. We describe a rare,previously undescribed anatomic variant of the LGV duringLaparoscopy-assisted radical gastrectomy. Methods The LGV drainagepattern was analyzed relative to intraoperative vascular anatomy in1713patients with gastric cancer who underwent Laparoscopy-assisted radicalgastrectomy from May2007to December2012. The incidence of the anatomicvariant was determined, and the diameter and length of the LGV and thedistances from the end of the LGV to the splenoportal confluence and theroot of the left gastric artery (LGA) were measured by abdominal CTreconstruction. Results In1713gastric cancer patients who underwentLaparoscopy-assisted radical gastrectomy, we found6patients had therare anatomic variant of the LGV, small vessels from the anterior andposterior walls of the lesser curvature of the stomach drained into theLGV. It lay close to the LGA in the high part of the lesser curvature,descended along the gastropancreatic fold, ran across the dorsal side ofthe splenic artery and drained into the splenic vein. The mean diameterand length of the LGV were5.10±0.40mm （range4.50-5.60mm） and37.40±5.19mm（range30.00-45.00mm）, respectively, and the mean distancefrom the end of the LGV to the splenoportal confluence was13.05±0.86mm（range12.10-14.60mm）. The closer the LGV and LGA were to the root,the greater the distance between them, with a mean13.85±1.02mm（range12.20-15.10mm） between the end of the LGV and the root of the LGA.Conclusions In this rare anatomic variant, the LGV descends along thegastropancreatic fold, runs across the dorsal side of the splenic artery and drains into the splenic vein. Knowledge of this rare, previouslyunreported anatomic variant will help avoid damage to the LGV duringLaparoscopy-assisted radical gastrectomy.