Editing Stomach (section)

== '''Lymphatic drainage''' ==

* Four zones of lymph nodes     (clockwise from top in diagram below)
** Superior gastric drains to      left gastric and paracardial nodes
** Pancreaticolienal drains to      left gastroepiploic and splenic nodes
** Inferior gastric and      subpyloric drains along the right gastroepiploic vascular pedicle
** Suprapyloric drains to right      suprapancreatic and hepatic nodes at porta hepatis
* All four zones eventually     drain into coeliac nodes and then into the thoracic duct
* Note the 'watershed' area     along a line drawn parallel to the greater curvature, two-thirds of the     way down the anterior surface
* Gastro-omental nodes often     occur several cm out into omentum
* Gastric cancer may     metastasize to any of the four nodal groups, regardless of cancer location
* To remember the important     lymph node stations (for D2 lymphadenectomy):
** 1, 3, 5 along lesser      curvature, proximal to distal
** 2, 4, 6 along greater      curvature
** Then the vessels: 7 left      gastric, 8 common hepatic, 9 coeliac
** Spleen: 10 splenic hilum, 11      proximal and distal splenic artery
** 12 hepatoduodenal
* D1: 1-7

*