Abstract:

Objective　To evaluate vascular anatomy and clinical significance relating to gastric cancer , as well their implications on laparoscopic assisted distal gastrectomy with D2 lymphadenectomy.　Methods　Living observation was carried out in 100 patients diagnosed as distal gastric cancer and undergoing laparoscopic gastrectomy with D2 lymphadenectomy.　Results　Although in different planes, gastric vascular network was consisted surrounding the pancreas, ascribing to intrinsic contact of flowing blood. In pancreatic spaces at superior margin of pancreatic tail left gastrcepiploic vessels were located in the area of the third part of splenic arteries. In retropancreatic space at inferior margin of pancreatic neck，superior mesenteric veins can be found in front of the uncinate process of pancreas and the third part of the duodenum. Right gastroepiploic vessels were located in gastric mesenteries inferior to gastric pylorus. In retropancreatic spaces at superior margin of pancreatic body, gastropancreatic folds, splenopancreatic folds and hepatopancreatic folds were landmarks respectively to locate left gastric arteries, splenic arteries and common hepatic arteries(branches of coeliac trunk). Conclusions　There ares many variations of perigastric vessels, exposed by the guidance of central landmarks of pancreas and concrete landmarks of vessel trunks and their furcations.

Key words:  Stomach, Neoplasm, Laparoscopy, Vascular anatomy