In case of doubt, contrast enhanced abdominal computerized tomography is the most sensitive diagnostic method for screening staple line leak, hematoma and abscess formation.8 An infected material in the gastrosplenic
area due to hematoma or staple line leak has the potential to spread of the bacterial content to the liver which can result in pyogenic liver abscess.
The preservation of the short gastric vessels and the left gastroepiploic artery is reassured because the gastrocolic and gastrosplenic
ligaments that contain those vessels are left untouched.
Three cases of the gastrosplenic
and the hepatomesenteric trunks.
We found that the pancreatic body and tail carcinomas were all located within the pancreatic capsule and no sign of metastasis, normal liver, splenomegaly, and short gastric vein, gastroepiploic vein, gastric coronary vein dilated in gastrosplenic
omentum was divided from the greater curvature close to the stomach wall using Ultracision or a Ligasure device.
Its normal position is provided by two fatty ligaments: the gastrosplenic
ligament, which connects the greater curvature of the stomach to the ventral aspect of the spleen, and the splenorenal ligament between the left kidney and the spleen, attaching the spleen to the posterior abdominal wall.
Present in approximately 10% of the population, accessory spleens arise from the fusion failure of the splenic anlage and reside in close proximity to the splenocolic and gastrosplenic
For stomach related procedures (subtotal / total gasterctomy), stomach was mobilized by incising gastrosplenic
omentum and left gastroepiploic vessels were identified.
The avascular area in gastrosplenic
ligament was subsequently incised with ultracision and the lesser sac was opened.
It is covered by visceral peritoneum except at the hilum where the gastrosplenic
omentum (carrying the splenic vessels) inserts.
The gastrocolic and gastrosplenic
ligaments are separated from the greater curvature using Sonicision (Covidien, Mansfield, MA).
The greater curvature was measured approximately 5 cm from the pyloric region towards its mid portion; the lesser sac was entered by opening the gastrocolic ligament with LigaSure; (3) mobilization of greater curvature: this was accomplished by ultrasonic dissection of short gastric vessels and gastrosplenic
and gastrocolic ligaments staying in the plane between the gastric wall and the gastroepiploic vessels, up to the angle of His.