Gastric Cancer

, Volume 8, Issue 4, pp 209–213 | Cite as

Confirmation of the posterior gastric artery using multi-detector row computed tomography

  • Takehiro Okabayashi
  • Michiya Kobayashi
  • Satoshi Morishita
  • Takeki Sugimoto
  • Toyokazu Akimori
  • Tsutomu Namikawa
  • Ken Okamoto
  • Norihiro Hokimoto
  • Keijiro Araki
Original article



The blood supply of the stomach is well characterized. Although the posterior gastric artery (PGA) is the second most important artery supplying the upper third of the stomach, the main features and clinical importance of the PGA have not been established. The aim of this study was to use multi-detector row computed tomography (MD-CT) to investigate the features of the PGA with respect to its incidence, location and size, and to correlate the findings with clinical practice.


In August 2004, 50 preoperative patients (33 men and 17 women) were evaluated prospectively by MD-CT. Informed consent for the present study was accepted at Kochi Medical School. The length of the PGA, from the root of the splenic artery, and the internal diameter of the PGA were examined. Correlations between body mass index (BMI) and the observed features of the PGA were investigated.


The PGA was recognized in all patients. In 49 (98%) patients, the PGA branched from the splenic artery. In 1 (2%) patient, the PGA originated from the root of the celiac trunk. The PGA was discernible for a length of 4.2–14.3 cm (mean, 9.1 cm) from the root of the splenic artery, and the internal diameter of the PGA was 0.5–2.1 mm (mean, 1.0 mm). BMI did not correlate with PGA length or internal diameter.


Our current study suggested that the anatomical and clinical features of the PGA can be shown by clinical methods, and that these features are useful in planning surgical treatment.

Key words

Posterior gastric artery (PGA) Multi-detector row computed tomography (MD-CT) Gastric carcinoma Lymph node metastasis 


  1. 1.
    Vandamme, JP, Bonte, J 1988The blood supply of the stomachActa Anat (Basel)1318996Google Scholar
  2. 2.
    Vandamme, JP, Bonte, J 1986Systematisation of the arteries in the splenic hilusActa Anat (Basel)12521724Google Scholar
  3. 3.
    DiDio, LJ, Christoforidis, AJ, Chandnani, PC 1980Posterior gastric artery and its significance as seen in angiogramsAm J Surg1393337CrossRefPubMedGoogle Scholar
  4. 4.
    Pitynski, K, Skawina, A, Lipczynski, W, Polakiewicz, J, Walocha, J 1996The posterior gastric and superior polar arteries in human fetusesFolia Morphol (Warsz)55439Google Scholar
  5. 5.
    Trubel, W, Turkof, E, Rokitansky, A, Firbas, W 1985Incidence, anatomy and territories supplied by the posterior gastric arteryActa Anat (Basel)1242630Google Scholar
  6. 6.
    Berens, AS, Aluisio, FV, Colborn, GL, Grey, SW, Skandalakis, JE 1991The incidence and significance of the posterior gastric artery in human anatomyJ Med Assoc Ga804258PubMedGoogle Scholar
  7. 7.
    Yu, W, Whang, I 1990Surgical implication of the posterior gastric arteryAm J Surg1594202PubMedGoogle Scholar
  8. 8.
    Trubel, W, Rokitansky, A, Turkof, E, Firbas, W 1988Correlations between posterior gastric artery and superior polar artery in human anatomyAnat Anz16721923PubMedGoogle Scholar
  9. 9.
    Suzuki, K, Prates, JC, DiDio, LJ 1978Incidence and surgical importance of the posterior gastric arteryAnn Surg1871346PubMedGoogle Scholar
  10. 10.
    Okabayashi, T, Gotoda, T, Kondo, H, Inui, T, Ono, H, Saito, D,  et al. 2000Early carcinoma of the gastric cardia in Japan: is it different from that in West?Cancer8925559CrossRefPubMedGoogle Scholar
  11. 11.
    Nakagawa, N 1992Rationale for dissection of lymph node associated with gastric carcinoma located at the greater curvature of the stomach — the correlation between the pattern of lymph node metastasis and the distribution of blackened lymph node by vital staining using activated carbon particles (CH 40) (in Japanese)Jpn J Gastroenterol Surg2524609Google Scholar
  12. 12.
    Okabayashi, T, Kobayashi, M, Sugimoto, T, Ohara, S, Okamoto, K, Matsuura, K,  et al. 2005Posterior gastric artery in angiograms and its surgical importanceHepatogastroenterology52298301PubMedGoogle Scholar
  13. 13.
    Stemmler, BJ, Paulson, EK, Thornton, FJ, Winters, SR, Nelson, RC, BM. Dual, Clary 2004-Phase 3D MDCT angiography for evaluation of the liver before hepatic resectionAJR Am J Roentgenol18315517PubMedGoogle Scholar
  14. 14.
    Duddalwar, VA 2004Multislice CT angiography: a practical guide to CT angiography in vascular imaging and interventionBr J Radiol77S2738PubMedGoogle Scholar
  15. 15.
    Guven, K, Acunas, B 2004Multidetector computed tomography angiography of the abdomenEur J Radiol524455CrossRefPubMedGoogle Scholar
  16. 16.
    Napoli, A, Fleischmann, D, Chan, FP, Catalano, C, Hellinger, JC, Passariello, R,  et al. 2004Computed tomography angiography: state-of-the-art imaging using multidetector-row technologyJ Comput Assist Tomogr28S3245PubMedGoogle Scholar
  17. 17.
    Guan, YS, Zheng, XH, Zhou, XP, Huang, J, Sun, L, Chen, X,  et al. 2004Multidetector CT in evaluating blood supply of hepatocellular carcinoma after transcatheter arterial chemoembolizationWorld J Gastroenterol1021279PubMedGoogle Scholar
  18. 18.
    Matsuki, M, Kani, H, Tatsugami, F, Yoshikawa, S, Narabayashi, I, Lee, SW,  et al. 2004Preoperative assessment of vascular anatomy around the stomach by 3D imaging using MDCT before laparoscopy-assisted gastrectomyAJR Am J Roentgenol18314551PubMedGoogle Scholar
  19. 19.
    Foley, WD, Kerimoglu, U 2004Abdominal MDCT: liver, pancreas, and biliary tractSemin Ultrasound CT MR2512244CrossRefPubMedGoogle Scholar
  20. 20.
    Kato, M 1995Study on feeding arteries and lymphatic drainage of remnant stomach cancer using angiography and fine activated carbon particles (in Japanese with English abstract)Nippon Geka Gakkai Zasshi (J Jpn Surg Soc)96807Google Scholar
  21. 21.
    Katai, H, Maruyama, K, Sasako, M, Sano, T 1998Incidence of nodal metastasis around the superior border of the pancreas based on number of metastatic perigastric nodesGastric Cancer11157CrossRefPubMedGoogle Scholar
  22. 22.
    Japanese Gastric Cancer Association1999Japanese classification of gastric carcinoma 13th ed.KaneharaTokyoGoogle Scholar
  23. 23.
    Arai, K, Iwasaki, Y, Takahashi, T 2002Clinicopathological analysis of early gastric cancer with solitary lymph node metastasisBr J Surg8914357CrossRefPubMedGoogle Scholar
  24. 24.
    Gotoda, T, Yanagisawa, A, Sasako, M, Ono, H, Nakanishi, Y, Shimoda, T,  et al. 2000Incidence of lymph node metastasis from gastric cancer: estimation with a large number of cases at two large centersGastric Cancer321925PubMedGoogle Scholar
  25. 25.
    Choi, HJ, Kim, YH, Kim, SS, Hong, SH 2002Occurrence and prognostic implications of micrometastases in lymph nodes from patients with submucosal gastric carcinomaAnn Surg Oncol9139CrossRefPubMedGoogle Scholar
  26. 26.
    Shimada, S, Yagi, Y, Honmyo, U, Shiomori, K, Yoshida, N, Ogawa, M 2001Involvement of three or more lymph nodes predicts poor prognosis in submucosal gastric carcinomaGastric Cancer4549PubMedGoogle Scholar
  27. 27.
    Seto, Y, Shimoyama, S, Kitayama, J, Mafune, K, Kaminishi, M, Aikou, T,  et al. 2001Lymph node metastasis and preoperative diagnosis of depth of invasion in early gastric cancerGastric Cancer4348CrossRefPubMedGoogle Scholar
  28. 28.
    Seto, Y, Shimoyama, S, Kitayama, J, Mafune, K, Kaminishi, M, Aikou, T,  et al. 2004Lymph node metastasis and preoperative diagnosis of depth of invasion in early gastric cancer. Gastric Cancer Japan Clinical Oncology Group study 9501J Clin Oncol22276773Google Scholar
  29. 29.
    Yamaguchi, T, Sano, T, Katai, H, Sasako, M, Maruyama, K 2001Node-positive mucosal gastric cancer: a follow-up studyJpn J Clin Oncol311536CrossRefPubMedGoogle Scholar
  30. 30.
    Popiela, T, Kulig, J, Kolodziejczyk, P, Sierzega, M 2002Long-term results of surgery for early gastric cancerBr J Surg89103542CrossRefPubMedGoogle Scholar
  31. 31.
    Borie, F, Millat, B, Fingerhut, A, Hay, JM, Fagniez, PL, Sazce, BD,  et al. 2000Lymphatic involvement in early gastric cancerArch Surg135121823PubMedGoogle Scholar
  32. 32.
    Folli, S, Margagni, P, Roviello, F, De Manzoni, G, Marrelli, D, Saragoni, L,  et al. 2001for the Italian Research Group for Gastric Cancer (IRGGC). Risk factors for lymph node metastases and their prognostic significance in early gastric cancer (EGC)Jpn J Clin Oncol314959CrossRefPubMedGoogle Scholar
  33. 33.
    Osaka, H, Yashiro, M, Sawada, T, Katsuragi, K, Hirakawa, K 2004Is a lymph node detected by the dye-guided method a true sentinel node in gastric cancer?Clin Cancer Res10691218PubMedGoogle Scholar
  34. 34.
    Isozaki, H, Kimura, T, Tanaka, N, Satoh, K, Matsumoto, S, Ninomiya, M,  et al. 2004An assessment of the feasibility of sentinel lymph node-guided surgery for gastric cancerGastric Cancer714953CrossRefPubMedGoogle Scholar
  35. 35.
    Kim, MC, Kim, HH, Jung, GJ, Lee, JH, Choi, SR, Kang, DY,  et al. 2004Lymphatic mapping and sentinel node biopsy using 99 mTc tin colloid in gastric cancerAnn Surg2393837PubMedGoogle Scholar

Copyright information

© International and Japanese Gastric Cancer Association 2005

Authors and Affiliations

  • Takehiro Okabayashi
    • 1
  • Michiya Kobayashi
    • 1
  • Satoshi Morishita
    • 2
  • Takeki Sugimoto
    • 1
  • Toyokazu Akimori
    • 1
  • Tsutomu Namikawa
    • 1
  • Ken Okamoto
    • 1
  • Norihiro Hokimoto
    • 1
  • Keijiro Araki
    • 1
  1. 1.Department of SurgeryKochi Medical SchoolKochiJapan
  2. 2.Radiology DivisionKochi Medical SchoolKochiJapan

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