case_images: PMC10070824_01
case_images: Enhanced CT arterial phase shows vascular variation.
case_images: fsurg-10-1090910-g001.jpg
case_images: PMC10070824_01_fsurg-10-1090910-g001.jpg
case_images: F1
case_images: The common hepatic artery extended directly to bridge the gastroduodenal artery (GDA) without the proper hepatic artery, the right hepatic artery (RHA) emanated from the superior mesenteric artery (SMA), and the left hepatic lobe is supplied by the accessory left hepatic artery (ALHA) from the left gastric artery (LGA), and the celiac trunk and portal system were normal (Figure 1).
case_images: Perforation position.
case_images: fsurg-10-1090910-g002.jpg
case_images: PMC10070824_01_fsurg-10-1090910-g002.jpg
case_images: F2
case_images: For the surgical approach, we adopted the opposite stance and perforation to conventional gastric cancer surgery (Figure 2) and used a 3D laparoscope to allow a more detailed view of the anatomical levels.
case_images: Ulcerated high-medium differentiated adenocarcinoma (2 cm x 3 cm), muscular infiltration.
case_images: fsurg-10-1090910-g003.jpg
case_images: PMC10070824_01_fsurg-10-1090910-g003.jpg
case_images: F3
case_images: No cancerous tissue was seen in the omental tissue, 14 lymph nodes in the small curved side did not show cancer metastasis, and 6 lymph nodes in the large curved side did not show cancer metastasis (Figure 3).