Microsurgical Reconstruction of Right Gastroepiploic Artery with Middle Colic Artery for Preservation of Gastric Tube

  • NAKAMURA Yutaka
    Department of Plastic and Reconstructive Surgery, Nagoya University Hospital
  • TAKANARI Keisuke
    Department of Plastic and Reconstructive Surgery, Nagoya University Hospital
  • EBISAWA Katsumi
    Department of Plastic and Reconstructive Surgery, Nagoya University Hospital
  • SAWAMURA Hisashi
    Department of Plastic and Reconstructive Surgery, Nagoya University Hospital
  • KANBE Miki
    Department of Plastic and Reconstructive Surgery, Nagoya University Hospital
  • KAMEI Yuzuru
    Department of Plastic and Reconstructive Surgery, Nagoya University Hospital
  • FUJII Tsutomu
    Department of Gastroenterological Surgery ( Surgery II ), Nagoya University Hospital
  • KODERA Yasuhiro
    Department of Gastroenterological Surgery ( Surgery II ), Nagoya University Hospital
  • TORIYAMA Kazuhiro
    Department of Plastic and Reconstructive Surgery, Nagoya City University Hospital
  • YAGI Shunjiro
    Department of Plastic and Reconstructive Surgery, Tottori University Hospital

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Other Title
  • 中結腸動脈を用いて胃管の栄養動脈である右胃大網動脈を再建した経験

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Description

In gastric tube reconstruction for esophagectomy, the blood flow to the gastric tube is mainly supplied by the gastroduodenal artery ( GDA ) via the right gastroepiploic artery ( RGEA ) . Ablation of RGEA in pylorus-preserving pancreaticoduodenectomy ( PPPD ) for pancreatic head cancer may cause ischemia of the gastric tube. The middle colic artery ( MCA ), splenic artery and jejunal artery are potential choices of donor vessel to reconstruct RGEA. We report a case of microsurgical reconstruction of RGEA with MCA, which was ligated during the operation for preservation of the gastric tube. The postoperative course was uneventful and the flow of RGEA was confirmed by CT angiography on the eighth postoperative day. It seemed reasonable to use MCA for the reconstruction of RGEA in that the positions of donor and recipient vessels are close and the sacrifice of blood flow to other organs is limited.

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