Morphometric Variations of the Left Gastric Artery in Thai Cadavers: A Tri-Parametric Analysis

Abstract

This is the first cadaveric study in a Thai population that simultaneously evaluates the origin, caliber, and bifurcation angle of the left gastric artery (LGA) using a tri-parametric approach, providing population-specific morphometric data relevant to gastrointestinal and hepatobiliary surgery. The LGA is a key vessel supplying the stomach and distal esophagus, and anatomical variations may complicate surgical access and increase intraoperative risks. Thirty formalin-fixed adult Thai cadavers (14 males, 16 females) were dissected using standard anatomical techniques to expose the celiac trunk and trace the LGA. Parameters recorded included origin site, internal diameter, and bifurcation angle. Branching patterns were classified, with interobserver agreement assessed using Cohen’s kappa coefficient. Descriptive statistics, chi-square tests, Mann-Whitney U tests, and intra-class correlation coefficients were performed. Four distinct LGA origin types were identified: celiac trunk (80 %), abdominal aorta (10 %), splenic artery (3.3 %), and accessory left hepatic artery type (6.7 %). The mean bifurcation angle was 78.23 ± 21.46° (range: 35° - 120°), with 53.3 % between 61° - 90°. The mean internal diameter was 2.51 ± 0.66 mm, significantly larger in females than in males (p = 0.026). No sex differences were found in origin or bifurcation angle. This study provides novel morphometric data integrating LGA origin, caliber, and angulation in a single cohort. These findings underscore the importance of anticipating LGA variability to optimize surgical planning, risk stratification, and imaging interpretation, ultimately contributing to safer and more individualized gastrointestinal and hepatobiliary procedures.