Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 14, 2015; 21(22): 6944-6951
Published online Jun 14, 2015. doi: 10.3748/wjg.v21.i22.6944
Study of celiac artery variations and related surgical techniques in gastric cancer
Yuan Huang, Guang-Chuan Mu, Xin-Gan Qin, Zhi-Bai Chen, Jin-Ling Lin, Yan-Jun Zeng
Yuan Huang, Guang-Chuan Mu, Xin-Gan Qin, Zhi-Bai Chen, Jin-Ling Lin, Department of Gastrointestinal Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Yan-Jun Zeng, Beijing University of Technology, Beijing 100022, China
Author contributions: Huang Y and Lin JL performed the majority of experiments; Zeng YJ and Chen ZB provided analytical tools and were also involved in editing the manuscript; Huang Y designed the study; and Mu GC wrote the manuscript.
Ethics approval: This study has been approved by the medical ethics committee of the First Affiliated Hospital of Guangxi Medical University.
Conflict-of-interest: There is no conflict of interest among the authors of this study and no objection to the selection and order of the authors
Data sharing: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yuan Huang, MB, Department of Gastrointestinal Surgery, the First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Street, Nanning 530021, Guangxi Zhuang Autonomous Region, China. huangyuan_09@163.com
Telephone: +86-771-5356701 Fax: +86-771-5356559
Received: January 9, 2015
Peer-review started: January 9, 2015
First decision: January 22, 2015
Revised: February 27, 2015
Accepted: April 3, 2015
Article in press: April 3, 2015
Published online: June 14, 2015
Processing time: 160 Days and 17.2 Hours
Abstract

AIM: To investigate celiac artery variations in gastric cancer patients and the impact on gastric cancer surgery, and also to discuss the value of the ultrasonic knife in reducing the risk caused by celiac artery variations.

METHODS: A retrospective analysis was conducted to investigate the difference in average operation time, intraoperative blood loss, number of harvested lymph nodes, average postoperative drainage within 3 d, and postoperative hospital stay between the group with vascular variations and no vascular variations, and between the ultrasonic harmonic scalpel and conventional electric scalpel surgery group.

RESULTS: One hundred and fifty-eight cases presented with normal celiac artery, and 80 presented with celiac artery variation (33.61%). The average operation time, blood loss, average drainage within 3 d after surgery in the celiac artery variation group were significantly more than in the no celiac artery variation group (215.7 ± 32.7 min vs 204.2 ± 31.3 min, 220.0 ± 56.7 mL vs 163.1 ± 52.3 mL, 193.6 ± 41.4 mL vs 175.3 ± 34.1 mL, respectively, P < 0.05). In celiac artery variation patients, the average operation time, blood loss, average drainage within 3 d after surgery in the ultrasonic harmonic scalpel group were significantly lower than in the conventional electric scalpel surgery group (209.5 ± 34.9 min vs 226.9 ± 29.4 min, 207.5 ± 57.1 mL vs 235.6 ± 52.9 mL, 184.4 ± 38.2 mL vs 205.0 ± 42.9 mL, respectively, P < 0.05), and the number of lymph node dissections was significantly higher than in the conventional surgery group (25.5 ± 9.2 vs 19.9 ± 7.8, P < 0.05).

CONCLUSION: Celiac artery variation increases the difficulty and risk of radical gastrectomy. Preoperative imaging evaluation and the application of ultrasonic harmonic scalpel are conducive to radical gastrectomy.

Keywords: Celiac artery; Variation; MSCTA; Ultrasonic harmonic scalpel; Gastric cancer

Core tip: Celiac artery variation is quite common in gastric cancer patients, and may obviously increase the difficulty and risk of radical gastrectomy with D2 lymphadenectomy. With the development of imaging techniques, not only the accuracy of preoperative staging, but also the individualized image information about celiac artery variation will be improved. Meanwhile, the application of new technology such as ultrasonic harmonic scalpel is conducive to radical gastrectomy with D2 lymphadenectomy and could reduce the risk caused by celiac artery variation; therefore, its utilization is to be recommended.