The Gastrocolic Ligament and the Omentum

The gastrocolic ligament attaches the greater curvature of the stomach to the anterior surface of the transverse colon and extends anteriorly as an apron to become the omentum covering the colon and small bowel in the peritoneal cavity. The gastrocolic ligament is in continuity with the gastrosplenic ligament on the left side of the abdomen, and it is fused with the transverse meso-colon on the right side of the abdomen as it is inserted and attached to the retroperitoneum behind the pylorus and anterior to the head of the pancreas.

The vascular landmarks of the gastrocolic ligament are the left and right gastroepiploic vessels that course along the greater curvature of the stomach. The left gas-troepiploic vessels are branches of the distal splenic artery and vein. They run from the splenic hilum in the gastrosplenic ligament, which continues to be the gas-trocolic ligament, and run along the greater curvature of the stomach to anastomose with the right gastroepi-ploic artery and vein. The right gastroepiploic artery is a branch of the gastroduodenal artery arising anterior to the head of the pancreas and coursing anteriorly in the fused gastrocolic ligament and transverse mesocolon, then continuing in the gastrocolic ligament along the greater curvature of the stomach. The right gastroepiploic vein joins the middle colic vein to form the gas-trocolic trunk and drain into the superior mesenteric vein anterior to the head of the pancreas5 and, in most cases, medial to the origin of the right gastroepiploic artery.

Tables 6-1 and 6-2 summarize the vessels within the peritoneal ligaments in the supramesocolic compartment. These vessels serve as anatomic landmarks to follow the pathways of lymphatic drainage of the liver, stomach, and spleen.

Table 6-2. Peritoneal Ligaments Derived from the Ventral Mesogastrium and their Vascular Landmarks

Peritoneal ligaments Vascular landmarks

Gastrohepatic ligament Left gastric artery and vein

Right gastric artery and vein Aberrant left hepatic artery Hepatoduodenal ligament Hepatic artery

Portal vein and parabillary plexus

Falciform ligament Vessels in the falciform ligament

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