Abstract：
BACKGROUND: Knowledge of celiac trunk anatomy is important in gastrointestinal surgery, hepatopancreatobiliary surgery, transplantation and interventional radiology. Variations in the celiac trunk are common and should be predicted prior to these interventions.
METHODS: A 58-year-old woman was admitted to our department for surgical treatment of gastric cancer (GC) confirmed by gastroduodenoscopy and gastric antrum biopsy. In the contrast-enhanced computed tomography (CT), we found an absence of both the celiac trunk artery (CA) and the common hepatic artery (CHA). Therefore, we used computerized three-dimensional (3D) vascular reconstruction technology to reconstruct the abdominal trunk and its branch vessels before operation.
RESULTS: Computerized 3D vascular reconstruction confirmed an extremely rare vascular anomaly: the absence of both CA and CHA. The splenic artery (SA) and gastroduodenal artery (GDA) originated from the abdominal aorta (AA). The left gastric artery (LGA) originated from the AA directly above the junction of SA and the GDA. The left hepatic artery (LHA) originated from the left gastric artery (LGA). The right hepatic artery (RHA) originated from the superior mesenteric artery (SMA). Laparoscopic radical resection of GC was performed. This anomaly was also confirmed intraoperatively. This patient was discharged on the 10th day after surgery without any postoperative complication. There were no signs of tumor recurrence during the 6-month follow-up.
CONCLUSIONS: Correct identification of abnormal abdominal large blood vessels and their relationship with tumors before surgery is of great significance to avoid intraoperative blood vessel damage, major postoperative complications and the missing of lymph node dissection.
METHODS: A 58-year-old woman was admitted to our department for surgical treatment of gastric cancer (GC) confirmed by gastroduodenoscopy and gastric antrum biopsy. In the contrast-enhanced computed tomography (CT), we found an absence of both the celiac trunk artery (CA) and the common hepatic artery (CHA). Therefore, we used computerized three-dimensional (3D) vascular reconstruction technology to reconstruct the abdominal trunk and its branch vessels before operation.
RESULTS: Computerized 3D vascular reconstruction confirmed an extremely rare vascular anomaly: the absence of both CA and CHA. The splenic artery (SA) and gastroduodenal artery (GDA) originated from the abdominal aorta (AA). The left gastric artery (LGA) originated from the AA directly above the junction of SA and the GDA. The left hepatic artery (LHA) originated from the left gastric artery (LGA). The right hepatic artery (RHA) originated from the superior mesenteric artery (SMA). Laparoscopic radical resection of GC was performed. This anomaly was also confirmed intraoperatively. This patient was discharged on the 10th day after surgery without any postoperative complication. There were no signs of tumor recurrence during the 6-month follow-up.
CONCLUSIONS: Correct identification of abnormal abdominal large blood vessels and their relationship with tumors before surgery is of great significance to avoid intraoperative blood vessel damage, major postoperative complications and the missing of lymph node dissection.
摘要：
背景：了解腹腔干解剖在胃肠道手术中很重要，肝胰胆管手术,移植和介入放射学。腹腔干的变化是常见的，应在这些干预措施之前进行预测。
方法：一名58岁的女性因胃十二指肠镜和胃窦活检证实的胃癌（GC）而入院。在对比增强计算机断层扫描（CT）中，我们发现腹腔干动脉(CA)和肝总动脉(CHA)均缺失.因此,我们使用计算机三维（3D）血管重建技术在术前重建腹部主干及其分支血管。
结果：计算机3D血管重建证实了一种极其罕见的血管异常：CA和CHA均缺失。脾动脉（SA）和胃十二指肠动脉（GDA）起源于腹主动脉（AA）。左胃动脉（LGA）起源于SA和GDA交界处正上方的AA。左肝动脉(LHA)起源于左胃动脉(LGA)。右肝动脉（RHA）起源于肠系膜上动脉（SMA）。行腹腔镜胃癌根治术。术中也证实了这种异常。该患者于手术后第10天出院，无任何术后并发症。在6个月的随访中没有肿瘤复发的迹象。
结论：术前正确识别腹部大血管异常及其与肿瘤的关系对避免术中血管损伤具有重要意义。术后主要并发症及淋巴结清扫缺失。
方法：一名58岁的女性因胃十二指肠镜和胃窦活检证实的胃癌（GC）而入院。在对比增强计算机断层扫描（CT）中，我们发现腹腔干动脉(CA)和肝总动脉(CHA)均缺失.因此,我们使用计算机三维（3D）血管重建技术在术前重建腹部主干及其分支血管。
结果：计算机3D血管重建证实了一种极其罕见的血管异常：CA和CHA均缺失。脾动脉（SA）和胃十二指肠动脉（GDA）起源于腹主动脉（AA）。左胃动脉（LGA）起源于SA和GDA交界处正上方的AA。左肝动脉(LHA)起源于左胃动脉(LGA)。右肝动脉（RHA）起源于肠系膜上动脉（SMA）。行腹腔镜胃癌根治术。术中也证实了这种异常。该患者于手术后第10天出院，无任何术后并发症。在6个月的随访中没有肿瘤复发的迹象。
结论：术前正确识别腹部大血管异常及其与肿瘤的关系对避免术中血管损伤具有重要意义。术后主要并发症及淋巴结清扫缺失。
