The gastrocolic trunk (Henle trunk) is a short venous trunk formed by the confluence of the right gastroepiploic vein and the anterior superior pancreaticoduodenal vein before they drain as a single vessel into the anterior surface of the superior mesenteric vein. In some individuals the right colic vein also joins this trunk before its SMV entry. It is the key venous landmark in the anterior approach to the SMV during right colectomy.
The gastrocolic trunk is the critical landmark identified during laparoscopic right hemicolectomy and extended right hemicolectomy with CME (complete mesocolic excision). Central vascular ligation requires division of the right colic and ileocolic pedicles at their SMV origin, guided by identification of the gastrocolic trunk at the anterior SMV surface. Inadvertent injury to the SMV at the trunk entry point during blunt dissection causes massive mesenteric venous haemorrhage. The trunk is also a landmark in pancreaticoduodenectomy where the SMV-portal vein tunnel dissection begins at this level.
The gastrocolic trunk at the anterior SMV surface is the central vascular landmark for laparoscopic right hemicolectomy with CME; inadvertent avulsion of the trunk or its component veins during mesenteric mobilisation causes major venous haemorrhage from the SMV wall requiring immediate vascular control and repair.
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