Anterior Perspective of the Right Gastric Artery

Description

Arising most often from the proper hepatic artery, the right gastric artery courses inferiorly and medially toward the pylorus, then runs leftward along the lesser curvature between the layers of the lesser omentum. From an anterior perspective you would expect it to lie against the proximal duodenum and gastric antrum, with the liver positioned superiorly and the hepatoduodenal ligament framing the proximal segment. Fine branches penetrate the anterior and posterior gastric walls while the vessel approaches its anastomosis with the left gastric artery near the incisura angularis. Small but constant. During sleeve gastrectomy, attention to the lesser curvature vasculature helps prevent devascularization of the remaining tubular stomach while controlling bleeding from the divided gastric wall. Although most dissection proceeds along the greater curvature with division of the short gastric arteries, the right gastric artery becomes relevant near the antrum when stapling is initiated 2 to 6 cm proximal to the pylorus, where an inadvertent injury can cause brisk hemorrhage or compromise antral perfusion. This view also reinforces the relationship between the right gastric artery and the hepatoduodenal ligament, a practical landmark when orienting near the porta hepatis. Surgeons can drop this asset directly into bariatric surgery teaching decks to label the right gastric artery, lesser curvature, pylorus, and staple line, or into anatomy and GI surgery chapters discussing arterial supply of the stomach and anastomotic networks. It also works well for preoperative counseling materials that explain why the antrum and pylorus are preserved in sleeve gastrectomy while the fundus and greater curvature are resected. Anatomical accuracy verified by SciePro's Medical Advisory Board.