Skip to main content
Springer Nature Link
Log in

Anatomical characteristics and classifications of gastrocolic trunk of Henle in laparoscopic right colectomy: preliminary results of multicenter observational study

  • 2019 SAGES Oral
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

As a key landmark during laparoscopic right colectomy, the classification and variation of the gastrocolic trunk of Henle (GTH) remains to be clarified. The aim of this nationwide multicenter study was to describe the characteristics of the GTH intra-operatively during laparoscopic right colectomies.

Methods

Three hundred seventy-one patients who underwent laparoscopic right colectomies from January 2018 to March 2019 in 25 hospitals across China were enrolled in the study. The length of the GTH, the classification with a precise description of confluent tributaries, and other variations were analyzed.

Results

Of the 371 patients, 363 had a GTH. The proportion of type-0, type-I, type-II, and type-III was 15.2% (n = 55), 54.8% (n = 199), 25.3% (n = 92), and 4.7% (n = 17), respectively. The average length of the GTH was 8.5 mm, ranging from 2 to 30 mm.

Conclusions

This is the first multicenter study with a large sample by which the GTH was classified based on laparoscopic intraoperative observation. Variations in the GTH were classified into four types based on the number of colic drainage veins (right colic, superior right colic, middle colic, accessory middle colic, and ileocolic veins), among which the right colic vein was the most common. The length of the GTH was relatively short, and thus might carry a risk of bleeding. Further clinical data should be correlated with the characteristics of the GTH.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Explore related subjects

Discover the latest articles and news from researchers in related subjects, suggested using machine learning.

References

  1. Schlinkert RT (1991) Laparoscopic-assisted right hemicolectomy. Dis Colon Rectum 34:1030–1031. https://doi.org/10.1007/bf02049971

    Article  CAS  PubMed  Google Scholar 

  2. Hazebroek EJ (2002) Color. Surg Endosc 16:949–953. https://doi.org/10.1007/s00464-001-8165-z

    Article  CAS  PubMed  Google Scholar 

  3. Kim JW, Kim JY, Kang BM, Lee BH, Kim BC, Park JH (2016) Short- and long-term outcomes of laparoscopic surgery vs open surgery for transverse colon cancer: a retrospective multicenter study. Onco Targets Ther 9:2203–2209. https://doi.org/10.2147/OTT.S103763

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Veldkamp R (2005) Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol 6:477–484. https://doi.org/10.1016/s1470-2045(05)70221-7

    Article  PubMed  Google Scholar 

  5. Hohenberger W, Weber K, Matzel K, Papadopoulos T, Merkel S (2009) Standardized surgery for colonic cancer: complete mesocolic excision and central ligation—technical notes and outcome. Colorectal Dis 11:354–364. https://doi.org/10.1111/j.1463-1318.2008.01735.x

    Article  CAS  PubMed  Google Scholar 

  6. He Z, Zhang S, Xue P, Yan X, Zhou L, Li J, Wang M, Lu A, Ma J, Zang L, Hong H, Dong F, Su H, Sun J, Zhang L, Zheng M, Feng B (2018) Completely medial access by page-turning approach for laparoscopic right hemi-colectomy: 6-year-experience in single center. Surg Endosc 33:959–965. https://doi.org/10.1007/s00464-018-6525-1

    Article  PubMed  Google Scholar 

  7. West NP, Hohenberger W, Weber K, Perrakis A, Finan PJ, Quirke P (2010) Complete mesocolic excision with central vascular ligation produces an oncologically superior specimen compared with standard surgery for carcinoma of the colon. J Clin Oncol 28:272–278. https://doi.org/10.1200/JCO.2009.24.1448

    Article  PubMed  Google Scholar 

  8. Açar HI, Cömert A, Avsar A, Çelik S, Kuzu MA (2014) Dynamic article: surgical anatomical planes for complete mesocolic excision and applied vascular anatomy of the right colon. Dis Colon Rectum 57:1169–1175

    Article  Google Scholar 

  9. Mike M, Kano N (2014) Laparoscopic surgery for colon cancer: a review of the fascial composition of the abdominal cavity. Surg Today 45:129–139. https://doi.org/10.1007/s00595-014-0857-9

    Article  PubMed  Google Scholar 

  10. Henle J (1876) Handbuch der systematischen Anatomie des Menschen. v. 3, Vieweg

  11. Descomps P (1912) Les veines mésentériques. J de l’Anat et physiol norm et path de l’homme et des animaux 48:337–376

    Google Scholar 

  12. Yamaguchi S, Kuroyanagi H, Milsom JW, Sim R, Shimada H (2002) Venous anatomy of the right colon: precise structure of the major veins and gastrocolic trunk in 58 cadavers. Dis Colon Rectum 45:1337–1340

    Article  Google Scholar 

  13. Miyazawa M, Kawai M, Hirono S, Okada K, Shimizu A, Kitahata Y, Yamaue H (2015) Preoperative evaluation of the confluent drainage veins to the gastrocolic trunk of Henle: understanding the surgical vascular anatomy during pancreaticoduodenectomy. J Hepato-Biliary-Pancreat Sci 22:386–391

    Article  Google Scholar 

  14. Ogino T, Takemasa I, Horitsugi G, Furuyashiki M, Ohta K, Uemura M, Nishimura J, Hata T, Mizushima T, Yamamoto H (2014) Preoperative evaluation of venous anatomy in laparoscopic complete mesocolic excision for right colon cancer. Ann Surg Oncol 21:429–435

    Article  Google Scholar 

  15. Lange JF, Koppert S, van Eyck CH, Kazemier G, Kleinrensink GJ, Godschalk M (2000) The gastrocolic trunk of Henle in pancreatic surgery: an anatomo-clinical study. J Hepato-biliary-pancreat Surg 7:401–403

    Article  CAS  Google Scholar 

  16. Alsabilah JF, Razvi SA, Albandar MH, Kim NK (2017) Intraoperative archive of right colonic vascular variability aids central vascular ligation and redefines gastrocolic trunk of henle variants. Dis Colon Rectum 60:22–29

    Article  Google Scholar 

  17. Lee SJ, Park SC, Kim MJ, Sohn DK, Oh JH (2016) Vascular anatomy in laparoscopic colectomy for right colon cancer. Dis Colon Rectum 59:718–724

    Article  Google Scholar 

  18. Gao Y, Lu Y (2018) Variations of gastrocolic trunk of henle and its significance in gastrocolic surgery. Gastroenterol Res Pract 2018:3573680. https://doi.org/10.1155/2018/3573680

    Article  PubMed  PubMed Central  Google Scholar 

  19. Gillot C, Hureau J, Aaron C, Martini R, Thaler G, Michels N (1964) The superior mesenteric vein, an anatomic and surgical study of eighty-one subjects. J Int Coll Surg 41:339

    CAS  PubMed  Google Scholar 

  20. Jin G, Tuo H, Sugiyama M, Oki A, Abe N, Mori T, Masaki T, Atomi Y (2006) Anatomic study of the superior right colic vein: its relevance to pancreatic and colonic surgery. Am J Surg 191:100–103. https://doi.org/10.1016/j.amjsurg.2005.10.009

    Article  PubMed  Google Scholar 

  21. Kimura W (2000) Surgical anatomy of the pancreas for limited resection. J Hepato-Biliary-Pancreat Surg 7:473–479. https://doi.org/10.1007/s005340070017

    Article  CAS  Google Scholar 

  22. Sakaguchi T, Suzuki S, Morita Y, Oishi K, Suzuki A, Fukumoto K, Inaba K, Kamiya K, Ota M, Setoguchi T, Takehara Y, Nasu H, Nakamura S, Konno H (2010) Analysis of anatomic variants of mesenteric veins by 3-dimensional portography using multidetector-row computed tomography. Am J Surg 200:15–22. https://doi.org/10.1016/j.amjsurg.2009.05.017

    Article  PubMed  Google Scholar 

  23. Ignjatovic D, Spasojevic M, Stimec B (2010) Can the gastrocolic trunk of Henle serve as an anatomical landmark in laparoscopic right colectomy? A postmortem anatomical study. Am J Surg 199:249–254. https://doi.org/10.1016/j.amjsurg.2009.03.010

    Article  PubMed  Google Scholar 

  24. Ignjatovic D, Sund S, Stimec B, Bergamaschi R (2007) Vascular relationships in right colectomy for cancer: clinical implications. Tech Coloproctol 11:247

    Article  CAS  Google Scholar 

  25. Nesgaard JM, Stimec BV, Bakka AO, Edwin B, Ignjatovic D (2015) Navigating the mesentery: a comparative pre- and per-operative visualization of the vascular anatomy. Colorectal Dis 17:810–818. https://doi.org/10.1111/codi.13003

    Article  CAS  PubMed  Google Scholar 

  26. García-Ruiz A, Milsom JW, Ludwig KA, Marchesa P (1996) Right colonic arterial anatomy. Dis Colon Rectum 39:906–911. https://doi.org/10.1007/bf02053990

    Article  PubMed  Google Scholar 

  27. Ignjatovic D, Stimec B, Finjord T, Bergamaschi R (2004) Venous anatomy of the right colon: three-dimensional topographic mapping of the gastrocolic trunk of Henle. Tech Coloproctol 8:19–22

    Article  CAS  Google Scholar 

  28. Freund MR, Edden Y, Reissman P, Dagan A (2016) Iatrogenic superior mesenteric vein injury: the perils of high ligation. Int J Colorectal Dis 31:1649–1651. https://doi.org/10.1007/s00384-016-2624-4

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

Special thanks to the supports of the Chinese Society of Laparoscopic and Endoscopic Surgeons and the Chinese Society of Colorectal Surgeons to this study.

Funding

This work was supported by Shanghai Shen-kang Hospital Development Centre (16CR1011A), Shanghai Municipal Commission of Health and Family Planning Program (201640030), Shanghai Translational Medicine Collaborative Innovation Center Program (TM201701) and Natural Science Fund of Shanghai(18ZR1424100).

Author information

Author notes

  1. Zirui He and Hao Su contributed equally to this work.

Authors and Affiliations

  1. Ruijin Hospital Shanghai Jiaotong University School of Medicine, Shanghai, China

    Zirui He, Hao Su, Minhua Zheng & Bo Feng

  2. Second Affiliated Hospital of Fujian Medical University, Quanzhou, China

    Kai Ye

  3. The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

    Yueming Sun

  4. Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China

    Yincong Guo

  5. The First Hospital of Jilin University, Changchun, China

    Quan Wang

  6. Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China

    Yong Li

  7. Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China

    Dechang Diao

  8. Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, Fuzhou, China

    Chunkang Yang

  9. Tangdu Hospital, Air Force Medical University, Xi’an, China

    Nan Wang

  10. Xuanwu Hospital Capital Medical University, Beijing, China

    Ang Li

  11. Daping Hospital, Army Medical University, Chongqing, China

    WeiDong Tong

  12. Sun Yat-Sen University Cancer Center, Guangzhou, China

    Peirong Ding

  13. Peking Union Medical Collage Hospital, Chinese Academy of Medical Sciences, Beijing, China

    Yi Xiao

  14. The First Affiliated Hospital of Soochow University, Suzhou, China

    Xiaojun Zhou

  15. Sir Run Run Shaw Hospital of Zhejiang University, Hangzhou, China

    Zhangfa Song

  16. Qinghai University Affiliated Hospital, Xining, China

    Su Yan

  17. Beijing Friendship Hospital, Capital Medical University, Beijing, China

    Hongwei Yao

  18. West China Hospital, Nanchong, China

    Wenjian Meng

  19. Shanghai Tenth People’s Hospital of Tongji University, Shanghai, China

    Donglei Zhou

  20. First Affiliated Hospital of Harbin Medical University, Harbin, China

    Anlong Zhu

  21. Affiliated Hospital of Qingdao University, Qingdao, China

    Yuan Gao

  22. Changhai Hospital, Navy Military Medical University, Shanghai, China

    Hao Wang

  23. HuaShan Hospital, Fudan University Shanghai Medical College, Shanghai, China

    Yiming Zhou

  24. Fudan University Shanghai Cancer Center, Shanghai, China

    Xinxiang Li

  25. The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China

    Liang Kang

Authors
  1. Zirui He
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Hao Su
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Kai Ye
    View author publications

    You can also search for this author inPubMed Google Scholar

  4. Yueming Sun
    View author publications

    You can also search for this author inPubMed Google Scholar

  5. Yincong Guo
    View author publications

    You can also search for this author inPubMed Google Scholar

  6. Quan Wang
    View author publications

    You can also search for this author inPubMed Google Scholar

  7. Yong Li
    View author publications

    You can also search for this author inPubMed Google Scholar

  8. Dechang Diao
    View author publications

    You can also search for this author inPubMed Google Scholar

  9. Chunkang Yang
    View author publications

    You can also search for this author inPubMed Google Scholar

  10. Nan Wang
    View author publications

    You can also search for this author inPubMed Google Scholar

  11. Ang Li
    View author publications

    You can also search for this author inPubMed Google Scholar

  12. WeiDong Tong
    View author publications

    You can also search for this author inPubMed Google Scholar

  13. Peirong Ding
    View author publications

    You can also search for this author inPubMed Google Scholar

  14. Yi Xiao
    View author publications

    You can also search for this author inPubMed Google Scholar

  15. Xiaojun Zhou
    View author publications

    You can also search for this author inPubMed Google Scholar

  16. Zhangfa Song
    View author publications

    You can also search for this author inPubMed Google Scholar

  17. Su Yan
    View author publications

    You can also search for this author inPubMed Google Scholar

  18. Hongwei Yao
    View author publications

    You can also search for this author inPubMed Google Scholar

  19. Wenjian Meng
    View author publications

    You can also search for this author inPubMed Google Scholar

  20. Donglei Zhou
    View author publications

    You can also search for this author inPubMed Google Scholar

  21. Anlong Zhu
    View author publications

    You can also search for this author inPubMed Google Scholar

  22. Yuan Gao
    View author publications

    You can also search for this author inPubMed Google Scholar

  23. Hao Wang
    View author publications

    You can also search for this author inPubMed Google Scholar

  24. Yiming Zhou
    View author publications

    You can also search for this author inPubMed Google Scholar

  25. Xinxiang Li
    View author publications

    You can also search for this author inPubMed Google Scholar

  26. Liang Kang
    View author publications

    You can also search for this author inPubMed Google Scholar

  27. Minhua Zheng
    View author publications

    You can also search for this author inPubMed Google Scholar

  28. Bo Feng
    View author publications

    You can also search for this author inPubMed Google Scholar

Corresponding authors

Correspondence to Minhua Zheng or Bo Feng.

Ethics declarations

Disclosures

Drs. Zirui He, Hao Su, Kai Ye, Yueming Sun, Yincong Guo, Quan Wang, Yong Li, Dechang Diao, Chunkang Yang, Nan Wang, Ang Li, WeiDong Tong, Peirong Ding, Yi Xiao, Xiaojun Zhou, Zhangfa Song, Su Yan, Hongwei Yao, Wenjian Meng, Donglei Zhou, Anlong Zhu, Yuan Gao, Hao Wang, Yiming Zhou, Xinxiang Li, Liang Kang, Minhua Zheng and Bo Feng have no conflict of interest or financial ties to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

He, Z., Su, H., Ye, K. et al. Anatomical characteristics and classifications of gastrocolic trunk of Henle in laparoscopic right colectomy: preliminary results of multicenter observational study. Surg Endosc 34, 4655–4661 (2020). https://doi.org/10.1007/s00464-019-07247-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-019-07247-2

Keywords