The route from the anterior hepatic plexus via the cystic artery and/or duct is crucial for preserving gallbladder innervation. Lymph node dissection specifically in the hepatoduodenal ligament may affect the incidence of gallstones after gastrectomy. Furthermore, the route from the posterior hepatic plexus via the common bile duct and the cystic duct to the gallbladder should not be disregarded. Preservation of the plexus may attenuate the incidence of gallstone formation after gastrectomy.

The authors report a rare variation of the absence of the celiac trunk in a Japanese cadaver, with the left gastric, splenic, common hepatic, and superior mesenteric arteries arising independently from the abdominal aorta in the routine dissection of a 95-year-old Japanese male cadaver. The incidence and developmental and clinical significance of this variation is discussed with a detailed review of the literature. Knowledge of such case has important clinical significance in an abdominal operation or invasive arterial procedure, that is, Appleby procedure and liver transplantation, laparoscopic surgery, and radiological procedures in the upper abdomen.

There are three routes of innervation of the pyloric region in humans, wherein the route of the right gastric artery is most important for preserving pyloric region innervation. Function will be preserved by more than 80% by preserving the artery in pylorus-preserving pancreaticoduodenectomy (PPPD). However, the route of the infrapyloric artery should not be disregarded. This route is related to several arteries (the right gastroepiploic and gastroduodenal arteries), and the preserving of these arteries is advantageous for preserving pyloric innervation in PPPD. Concurrently, the nerves of Latarjet also play an important role in maintaining innervation of the antro-pyloric region in PPPD. This is why pyloric function is not damaged in some patients when the right gastric artery is dissected or damaged in PPPD.

To investigate the distribution of ghrelin in different regions of stomach in Sprague-Dawley rat, and attempt to compare with those of humans and other mammalian species in this study, the stomach of rats was divided into five sections, cardia, fundus, greater curvature, lesser curvature and pylorus. Immunohistochemistry and Western blotting were performed to investigate the ghrelin-producing cells. The immunolocalization and protein levels of ghrelin differed significantly in different regions of stomach in rats. It was present at a high level in the greater curvature of the pars glandularis, and the lesser curvature. In the fundus and pylorus, no ghrelin immunoreactive cells were detected. In this study, we elucidated the distribution of ghrelin-producing cells in different regions of rat stomach in detail for the first time. It is further considered that the differences of ghrelin distribution in stomach of different species may induce different stimulatory effects on fat accumulation and metabolism.