关键词: 胃短血管, 远端胃切除术, 近端胃切除术, 全胃切除术, 出血

Abstract: During gastrectomy for gastric cancer, the short gastric vessels are a challenge in radical resection due to their complex anatomy and proximity to the splenic hilum and pancreatic tail, which can easily lead to intraoperative bleeding and postoperative complications. In distal gastrectomy, only 2 short gastric vessels at the inferior pole of the spleen need to be managed. These vessels are relatively long with a large operative space, and safe and effective lymph node dissection and vascular ligation can be achieved with minimal surgical skills. However, in proximal gastrectomy or total gastrectomy, the short gastric vessels at the superior pole of the spleen are short with a narrow operative space. The traditional bottom-up approach is prone to bleeding, and hemostasis is difficult in such cases. Adopting a “short gastric vessels first” strategy can address splenic hilum bleeding caused by visual field obstruction and excessive traction on the short gastric vessels under the traditional approach. This strategy improves surgical safety while ensuring the quality of lymph node dissection.

Key words: short gastric vessels, distal gastrectomy, proximal gastrectomy, total gastrectomy, hemorrhage