Surgical and Radiologic Anatomy

, Volume 40, Issue 4, pp 423–429 | Cite as

Anatomy of the right colic vein and pancreaticoduodenal branches: a surgical landmark for laparoscopic complete mesocolic excision of the right colon

  • Takaaki Osawa
  • Shunichiro Komatsu
  • Seiji Ishiguro
  • Tsuyoshi Sano
Original Article
  • 102 Downloads

Abstract

Purpose

Knowledge of mesenteric venous anatomy is important to safely perform laparoscopic complete mesocolic excision (CME) of the right colon. Despite their previously reported diversity, consistent features of the right colonic and pancreatic veins can be discerned. The objective of this study was to evaluate anatomical consistency of the right colic vein (RCV) and the pancreaticoduodenal vein associated with the colic vein (PDV-C).

Methods

This study included 125 consecutive patients undergoing contrast-enhanced multidetector-row CT of the abdomen. Images of 100 of these cases were retrospectively reviewed for the positioning of the colonic, gastric and pancreatic veins associated with the superior mesenteric vein (SMV). RCV were classified as three types: Type-I, running on the ventral aspect of the pancreatic head and draining into the right lateral wall of the SMV; Type-II, running apart from the pancreatic head and directly draining into the SMV; and Type-III, draining into the tributaries of the SMV.

Results

The RCV was identified in 88% of cases, in which the frequencies of Type-I, -II and -III anatomies were 84.1, 9.1, and 6.8%, respectively. All of the Type-I RCVs formed a common trunk with other veins, including the gastroepiploic vein (93.2%) and the superior RCV (59.5%). The PDV-C joined the RCV in 63.5% of the Type-I cases.

Conclusions

Anatomical consistency of the RCV together with the PDV-C is present in the majority of cases. Our findings support the view that the appearance of the veins is a useful landmark for laparoscopic CME of the right colon.

Keywords

Colectomy Dissection Laparoscopy Mesenteric veins Mesocolon 

Notes

Acknowledgements

We are grateful to Takahiro Hashimoto in the Division of Mathematics, Aichi Medical University for valuable comments on the manuscript. We are also grateful to Toyohiro Ohta in the Department of Radiology, Aichi Medical University for valuable comments on radiological methods.

Compliance with ethical standards

Ethical approval

The study protocol was approved by the institutional review board of Aichi Medical University Hospital.

Conflict of interest

Osawa T, Komatsu S, Ishiguro S and Sano T have no conflict of interest to declare.

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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Gastroenterological SurgeryAichi Medical UniversityNagakuteJapan

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