Origin of the Left Gastroepiploic Artery
Yes, the left gastroepiploic artery is derived from the splenic artery. According to anatomical evidence, the left gastroepiploic artery consistently originates from the splenic artery, though the exact pattern of origin can vary.
Anatomical Origin Patterns
The left gastroepiploic artery (LGEA) arises from the splenic artery in three main patterns:
- Type I (Truncular origin): LGEA arises directly from the main trunk of the splenic artery in approximately 20.25% of cases 1
- Type II (Distal origin): LGEA originates from an inferior polar branch of the splenic artery in about 68.35% of cases - this is the most common pattern 1
- Type III (Common trunk): LGEA arises from a common spleno-gastroepiploic trunk in approximately 11.4% of cases 1
Clinical Significance
Understanding the origin of the left gastroepiploic artery has important clinical implications:
- The LGEA supplies the greater curvature of the stomach along with branches to the greater omentum 2
- It forms an anastomosis with the right gastroepiploic artery along the greater curvature of the stomach 2
- This vessel is particularly important in gastric cancer surgery, as lymph nodes along the left gastroepiploic artery (station 4sb) are considered regional lymph nodes that may require dissection 3
Anatomical Variations
Several important variations of the left gastroepiploic artery have been documented:
- The LGEA may have an intrapancreatic course in some cases, where it pierces the pancreatic parenchyma before emerging to supply the stomach 2
- Duplication of the LGEA has been reported, where the vessel trifurcates into an omental branch, duplicated LGEA, and a main LGEA trunk 2
- The LGEA can give rise to accessory splenic arteries that travel through the gastrosplenic ligament to supply the spleen 4
Relationship to Other Vessels
The left gastroepiploic artery has important relationships with other vessels in the upper abdomen:
- It is closely related to the splenic hilar vessels and short gastric arteries 5
- The LGEA is considered part of the fundic branches of the stomach, along with short gastric arteries 6
- In the splenic hilum region, the LGEA is proximal to the first gastric branch and is included in lymph node station 10 (splenic hilar lymph nodes) 3
Surgical Considerations
Knowledge of the LGEA's origin is crucial during several surgical procedures:
- During spleen-preserving distal pancreatectomy with excision of splenic pedicle 1
- In gastric cancer surgery, particularly when performing lymphadenectomy of stations 4sb (left greater curvature LNs along the left gastroepiploic artery) and 10 (splenic hilar LNs) 3
- When using the gastroepiploic artery as a conduit for coronary artery bypass grafting (CABG) 3
- During gastric esophagoplasty procedures 1
Understanding these anatomical relationships helps surgeons avoid inadvertent injury to these vessels during procedures in the upper abdomen, particularly those involving the stomach, spleen, and pancreas.