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The incision follows at an angle of 45 degrees to the lesser curvature. [9] The staple line can, but need not, be oversewn. [9] After removal of the distal portion (including the antrum and the pylorus) of the stomach, a clamp is fitted at right angles to the greater curvature. [9]
The anterior gastric branches of anterior vagal trunk are branches of the anterior vagal trunk which supply the stomach. [1]One long branch of it runs from the lesser curvature or parallel to it in lesser omentum as far as the pyloric antrum to fan out into branches in a way like the digits of a crow's foot to supply the pyloric antrum and the anterior wall of pyloric canal.
The greater curvature, which begins at the cardiac notch, and arches backwards, passing inferiorly to the left, [1] is four or five times longer than the lesser curvature, [2] which attaches to the hepatogastric ligament and is supplied by the left gastric artery and right gastric branch of the hepatic artery. [1]
The anterior vagal trunk is responsible mainly for providing parasympathetic innervation to the lesser curvature of the stomach, pylorus, gallbladder, and biliary apparatus. [ 1 ] Anatomy
The greater curvature of the stomach (not involved with the previous closure of the stomach) is then connected to the first part of the jejunum in end-to-side anastomosis. The Billroth II always follows resection of the lower part of the stomach . The surgical procedure is called a partial gastrectomy and gastrojejunostomy.
The antrum rotates in opposite direction to the fundus of the stomach. This is the most common type of gastric volvulus, occurring in approximately 59% of cases, and it is usually associated with diaphragmatic defects. Strangulation and necrosis commonly occur with organoaxial gastric volvulus and have been reported in 5–28% of cases.
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Lower, accompanying the descending branches of the artery along the cardiac half of the lesser curvature of the stomach, between the two layers of the lesser omentum; Paracardial outlying members of the gastric lymph nodes, disposed in a manner comparable to a chain of beads around the neck of the stomach.