From the Research
The blood supply to the gastric conduit for esophagectomy primarily relies on the right gastroepiploic artery, which runs along the greater curvature of the stomach, as evidenced by the most recent study in 2024 1. The gastric conduit is the most common choice for esophagectomy, and its blood supply is crucial for preventing ischemia and anastomotic leakage.
- The right gastroepiploic artery is the main blood supply to the gastric conduit, and it is essential to preserve this artery during the procedure.
- The left gastric, short gastric, and left gastroepiploic vessels are typically divided during the procedure, making the gastric conduit dependent on blood flow from the right gastroepiploic artery via the gastroepiploic arcade.
- A study published in 2024 1 found that the blood flow ratio at the tip of the gastric conduit is a significant predictor of anastomotic leakage, highlighting the importance of preserving the blood supply to the tip of the conduit.
- Another study published in 2017 2 used indocyanine green fluorescence imaging to evaluate the gastric conduit perfusion during esophagectomy and found that visual assessment of the perfusion may underestimate the blood supply, emphasizing the need for careful evaluation of the blood supply during the procedure.
- The evidence suggests that preserving the whole vessel arcade of the greater curvature is essential for achieving good blood perfusion in the gastric tube, as reported in a study published in 2014 3.
- In cases where the right gastroepiploic artery needs to be ligated, a right gastroepiploic artery occlusion test can be performed to evaluate the blood circulation of the reconstructed gastric tube, as described in a study published in 2004 4.