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Management of Acute Intestinal Ischaemia
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Michael J. Stamos, John V. Gahagan
The coeliac artery branches from the aorta just below the diaphragmatic hiatus, typically at the level of the T12 vertebral body. It arises almost perpendicularly to the aorta, and it immediately gives off three branches: the left gastric artery, the common hepatic artery and the splenic artery. Together, these branches supply blood to the distal oesophagus, stomach, liver, gall bladder, duodenum, pancreas and spleen. There is extensive collateralisation amongst these branches, which helps protect the stomach from ischaemia. The common hepatic artery gives off the right gastric artery, which meets the left gastric artery along the lesser curve of the stomach. The splenic artery gives off the left gastroepiploic artery, which meets the right gastroepiploic artery (a branch of the hepatic artery) along the greater curve of the stomach. The liver receives approximately 60% to 70% of its blood supply from the portal vein, making the hepatic artery a minor contributor. This dual blood supply also protects the liver from ischaemia during insults to the mesenteric vasculature. The pancreas and duodenum receive blood from the pancreaticoduodenal arteries. The anterior and posterior branches of the superior pancreaticoduodenal artery arise from the common hepatic artery and meet with the anterior and posterior branches of the inferior pancreaticoduodenal artery, which arises from the SMA. The gall bladder receives blood through the cystic artery (usually as a branch of the right hepatic artery).
Gastrointestinal surgery in gynecologic oncology
Published in J. Richard Smith, Giuseppe Del Priore, Robert L. Coleman, John M. Monaghan, An Atlas of Gynecologic Oncology, 2018
Eileen M. Segreti, Stephanie Munns, Charles M. Levenback
The blood supply to the stomach is derived from the celiac trunk. The greater curvature of the stomach is supplied by the right and left gastroepiploic arteries. The lesser curvature is supplied by the right and left gastric arteries. The right gastric artery and the right gastroepiploic artery are branches of the common hepatic artery and gastroduodenal artery, respectively. The left gastric artery is a branch of the celiac trunk, and the left gastroepiploic artery is a branch of the splenic artery. Routes of venous drainage include the gastric and gastroepiploic veins as well as small tributaries of the esophageal veins.
Use of the stomach as an esophageal substitute
Published in Larry R. Kaiser, Sarah K. Thompson, Glyn G. Jamieson, Operative Thoracic Surgery, 2017
Arnulf H. Holscher, J. Rudiger Siewert
The third vessel of the celiac trunk, the common hepatic artery, turns to the right, in the direction of the hepatoduodenal ligament of the small omentum. There it divides into the hepatic and gastroduodenal arteries. The hepatic artery runs through the hepatoduodenal ligament to the liver and usually gives rise to the right gastric artery, which proceeds to the lesser curvature of the stomach. The right gastric artery may also originate from the gastroduodenal artery. The gastroduodenal artery runs posterior to the superior part of the duodenum distal to the pylorus and comes out caudad to the duodenum, where it divides into the right gastroepiploic and superior pancreaticoduodenal arteries. All gastric arteries anastomose between themselves directly or indirectly by intramural or extramural branches. Therefore, the ligation of two or even three gastric arteries preserves the blood supply of the stomach under normal circumstances.
Investigation of proper hepatic artery and gastroduodenal artery variations by multidetector computed tomography angiography method
Published in Acta Chirurgica Belgica, 2020
Arzu Ekingen, Mehmet Cudi Tuncer, Özgür Ertuğrul
A normal branching ratio of the PHA (left branch and right branch) and GDA (Figure 1) was found in 292 (43.52%) cases in our study. However, this was found in 61.3% of the 600 patients of Covey et al. [12], 63.9% of the 607 patients of Farghadani et al. [17], and 75.7% of the 1000 patients of Hiatt et al. [30]. In our study, the CHA was observed to be divided into three vessels (trifurcation of the CHA): the LHA, GDA, and right gastric artery (RGA). The PHA is absent (Figure 2) in 60 (8.94%) series. Similarly, Gurgacz et al. [31] observed trifurcation of the CHA in one cadaver.
Remote mentoring in laparotomic and laparoscopic cancer surgery during Covid-19 pandemic: an experimental setup based on mixed reality
Published in Medical Education Online, 2021
Michele Simone, Rocco Galati, Graziana Barile, Emanuele Grasso, Raffaele De Luca, Carmine Cartanese, Rocco Lomonaco, Eustachio Ruggieri, Anna Albano, Antonello Rucci, Giuseppe Grassi
The smartglasses enabled the trainees to correctly identify the anatomical variations of the gastric vascular vessels [11]. Specifically, by following the instructions of the surgeons in the operating room and by consulting the radiological images via the smartglasses, the trainees have identified an anatomical variant for the right gastric artery that originated from the gastroduodenal artery. Without the proposed innovation, it would be impossible for the trainees to benefit of this medical knowledge.