胃小弯侧动脉的应用解剖

Applied anatomy study on lesser curvature arteries of stomach

目的解剖观察胃小弯侧的动脉供应及其变异,为临床上腹部手术、胃癌介入治疗提供解剖学依据。方法随机收集经福尔马林处理过的74具成年尸体,观察胃动脉的起源、行径及其分支分布范围,并进行统计学处理。结果在本组标本中,胃左动脉起源于腹腔干者72例,占97.3%;起于肝左动脉者2例,占2.7%。胃左动脉发出副肝左动脉者4例,占5.4%;发出替代性肝左动脉者4例,占5.4%。另有4例其变异更为特殊,占5.4%,其中有2例,替代性肝左动脉直接由腹腔干发出,后者再发出3支胃动脉,供应食管下部、胃的贲门部和胃体前壁小弯侧的部分;1例胃左动脉的前、后支直接由腹腔干发出;另1例除拥有常规的胃的动脉来源外,腹腔干还直接发出1支粗大的胃动脉供应贲门部的右上份。胃右动脉起源于肝固有动脉者48例,占64.8%;起于肝总动脉者10例,占13.5%;起于肝左动脉者9例,占12.2%;起源于胃十二指肠动脉者7例,占9.5%。结论胃小弯侧动脉变异率较高,掌握其变化规律,对临床医生具有十分重要的意义。

Objective To observe the arterial supply and the variations of the lesser curvature,so as to provide the morphological basis for the clinical imaging and surgery. Methods A total of 74 cadavers were randomly collected, and the origins, course and branches of lesser curvature arteries were observed and recorded. Results Left gastric artery （ LGA ） originating from celiac trunk appeared in 72 cases （97.3 % ） while from left hepatic artery （LHA） appeared in 2 cases （2.7 % ）. Left gastric artery branched vice left hepatic artery appeared in 4 cases （5.4%） and alternative left hepatic artery appeared in 4 cases （5.4%）. The special variation about branches of LGA appeared in 4 cases （5.4%） ：alternative left hepatic artery（RLPA） directly originated from celiac trunk appeared in 2 cases, and then it branched three branches to supply the lower esophagus, cardia of stomach, and the lesser curvature of anterior wall of the stomach. The anterior and posterior gastric branches of LGA directly originated from celiac trunk appeared in one case;besides the regular artery sources there is a large gastric artery originated from celiac trunk supplying the upper right part of the cardia. Right gastric artery （RGA） originated from proper hepatic ar- tery （PHA） appeared in 48 cases （ 64.8 % ）, from common hepatic artery （CHA） in 10 cases （ 13.5 % ）, from left hepatic artery （ LHA ） in 9 cases （ 12.2% ） ,and from gastroduodenal artery in 7 cases （9.5%）. Conclusion The variations of lesser curvature arteries of stomach are complex. So it is important to pay close attention to master the changes.