From the Guidelines
The left gastric artery is located in the upper abdomen, originating from the celiac trunk, which branches directly from the abdominal aorta, and runs upward and to the left, traveling along the lesser curvature of the stomach, as described in the context of lymph node stations 1. The left gastric artery supplies blood to the upper part of the stomach, specifically the lesser curvature and the cardiac region, as well as the lower portion of the esophagus.
- It sits within the lesser omentum and forms anastomoses with the right gastric artery, which is crucial for understanding its role in gastric surgeries and cases of upper gastrointestinal bleeding.
- The left gastric artery is also significant in the context of portal hypertension, as it can become a site of portosystemic shunting through esophageal varices, since its esophageal branches communicate with systemic circulation.
- Recent studies, such as the 2023 expert consensus-based practical recommendations of the Korean Liver Cancer Association 1, highlight the importance of recognizing the anatomy of the celiac trunk and superior mesenteric artery, including the left gastric artery, for procedures like transarterial chemoembolization.
- The anatomy of the left gastric artery is critical for identifying vascular anatomy and tumor-feeding arteries, and its visualization is essential during celiac angiography, as noted in the recommendations 1.
From the Research
Location of the Left Gastric Artery
- The left gastric artery (LGA) typically arises from the celiac trunk, which is the first unpaired midline branch of the abdominal aorta 2, 3, 4.
- However, variations in the origin of the LGA have been reported, including cases where it arises independently from the abdominal aorta 2, 5.
- In one study, the LGA was found to arise from the anterior wall of the abdominal aorta at the level of the T12-L1 intervertebral disk, approximately 33.8 mm above the origin of the superior mesenteric artery (SMA) 2.
- The LGA is an important branch that supplies blood to the stomach, and its variation in origin can have significant implications for surgical and clinical practice 2, 3, 5.
Clinical Significance
- Knowledge of the variations in the origin of the LGA is crucial for surgeons and clinicians performing procedures such as liver transplants, celiac artery resection, and interventional radiology procedures like transarterial chemoembolization 3, 6, 5.
- The LGA is also important in the planning and performance of upper abdominal surgical procedures, including distal pancreatectomy with celiac axis resection (DP-CAR) 6.
- Reconstruction of the common hepatic artery, which may involve the LGA, can prevent ischemic complications and is an alternative to preoperative embolization of the celiac trunk 6.