부산대학교 도서관

Purpose: We aimed to conduct an objective and comprehensive evaluation of the venous system, which is regarded as important in gastrectomy, by using multi-detector row computed tomography (MDCT). Materials and Methods: We enrolled 100 Japanese patients (64 men and 36 women, mean age: 67.8 years) who underwent gastrectomy for gastric cancer without a branching anomaly of the common hepatic (CHA), splenic (SpA), and superior mesenteric arteries (SMA). We objectively evaluated the preoperative MDCT images regarding the left gastric (LGV), splenic (SpV), and inferior mesenteric veins (IMV). Results: We identified the LGV in 78 cases (78%). The identification rate was significantly improved by three-dimensional reconstruction of the MDCT images (P=0.01). The LGV was drained into the portal vein (PV) via the dorsal side of the CHA in 31 cases (39.7%), the SpV via the ventral side of the SpA in 21 cases (26.9%), and the PV via the dorsal side of the CHA in 15 cases (19.2%). At the 11p locus, the SpV was located in the caudal and middle third of the pancreas in 50 cases (50%). At the 11d locus, the SpV was located on the caudal side of the SpV in 40 cases (40%). We identified the IMV in 90 cases (90%), flowing into the SpV in 48 cases (53.3%). Conclusion: By using high-definition MDCT imaging, we could evaluate venous systems related to gastrectomy noninvasively, objectively, and comprehensively. The anatomical information objectively and comprehensively assessed in this study may contribute to improving gastrectomy procedure.