Angiographic Findings and Lymph Node Metastases of the Remnant Stomach Cancer

Makoto Kato, Shigeru Takahashi, Osamu Ikawa, Koji Fujii, Hiroshi Izumi, Atsushi Takenaka, Hajime Tokuda, Kiyoshi Sawai*, Shinji Okano*, Hiroki Taniguchi*, Toshio Takahashi*

Department of Surgery, Kyoto Second Red Cross Hospital
*First Department of Surgery, Kyoto Prefectural University of Medicine

We reviewed angiograms and lymph node metastases of 20 patients with cancer of the remnant stomach. 17 whose angiograms revealed tumor vessels or tumor staining of cancer were divided into two groups according to the method of the previous operation. In 5 patients whose left gastric artery had been preserved in a previous operation, the remnant stomach tumor received its main blood supply from, and the lymph node metastases were found along, the left gastric artery. In 12 patients whose left gastric artery had been divided in a previous operation, the remnant stomach tumor received its main blood supply from the posterior gastric artery, the left gastroepiploic artery, or the short gastric artery, and the lymph node metastases were found along the splenic artery. When the left subphrenic artery was the main blood supply of the remnant stomach tumor, lymph node metastases were found in the left cardiac region, in the lower thoracic paraesophageal region or in the peri-diaphragmatic area. In patients who had their remnant stomach reconstructed by the Billroth II method, the remnant stomach cancer sometimes received a part of its blood supply from the jejunal artery. In these patients, lymph node metastases were found along the jejunal artery or the superior mesenteric artery.

Key words
remnant stomach cancer, angiography of the remnant stomach, lymph node metastases of the remnant stomach cancer, angiographic findings of the remnant stomach cancer, operation for the remnant stomach cancer

Reprint requests
Makoto Kato Department of Surgery, Kyoto Second Red Cross Hospital
355-5 Haruobi-cho, Kamanza-Marutamachi-agaru, Kamiygo-ku, Kyoto, 602 JAPAN

Accepted
December 10, 1991

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