[A rare anatomical variation of ileocolic veins involving in gastrocolic vein trunk: case report and literature review].

Objective: Due to its various anatomical variations and numerous branches, the gastrocolic vein trunk (Henle trunk) is the most common site to develop bleeding and other complications in laparoscopic right hemicolectomy for colon cancer. This study aims to investigate the role of ileocolic vein (ICV) joining with Henle trunk, a rare anatomical variation. Methods: A rare case whose ICV was newly found to involve in the formation of Henle trunk during laparoscopic resection of right hemicolon cancer was reported as right gastroepiploic vein+ right colic vein+superior right colic vein+ICV. This anatomical variation was confirmed by multi-slice spiral CT coronal two-dimensional reconstruction of right hemicolon angiography. The literatures about ICV participating in formation of Henle trunk were systematically searched from PubMed, The Cochran Library, CNKI net and Wanfang database, and the occurrence probability and composition of its anatomical variation were analyzed. Results: This was a 47-year-old female patient who underwent laparoscopic right hemicolectomy. When the vessels were dissected during operation, it was found that ICV did not accompany the ileocolic artery, but directly flowed into Henle trunk. Two-dimensional reconstructed CT images of right hemicolon vessels showed that the composition of Henle trunk was rarely varied, which was composed of right gastroepiploic vein, right colonic vein, superior right colonic vein and ICV. Five literatures were enrolled from literature retrieval. A total of 12 cases with ICV participating in the construction of Henle trunk were reported, with a probability of 0.27%-6.31% and 6 forms of the formation of Henle trunk. In this case, Henle trunk was made up of right gastroepiploic vein, right colonic vein, upper right colonic vein and ICV, which was reported for the first time. Conclusions: ICV involving in Henle trunk is a rare vascular variation, and this type of variation should be fully recognized. Careful dissection during operation is necessary to prevent intraoperative bleeding caused by improper operation.目的： 胃结肠静脉干（Henle干）解剖学变异多样、属支众多，是腹腔镜右半结肠癌根治术最容易发生出血等并发症的部位。本研究旨在探讨回结肠静脉（ICV）参与Henle干构成这一罕见的解剖学变异形式。 方法： 报道1例腹腔镜右半结肠癌手术患者，术中发现ICV参与Henle干构成的新形式，胃网膜右静脉（RGEV）+右结肠静脉（RCV）+上右结肠静脉（SRCV）+ICV，并通过多层螺旋CT冠状面二维重建右半结肠血管造影获得证实。检索PubMed、Cochran Library、中国知网、万方医学网和维普数据库中ICV参与Henle干构成的文献报道，分析其解剖变异的发生概率和构成情况。 结果： 本例为47岁女性患者，行腹腔镜辅助根治性右半结肠切除术，术中解剖血管，发现ICV并未与回结肠动脉伴行，而直接汇入Henle干参与其构成。二维重建的右半结肠血管CT图像显示，Henle干的构成存在罕见变异，其具体构成为RGEV+RCV+SRCV+ICV。文献检索纳入5篇文献，共报道12例ICV参与Henle干构成，发生率为0.27%~6.31%，Henle干构成形式有6种。本例RGEV+RCV+SRCV+ICV构成为首次报道。 结论： ICV参与Henle干构成罕见，应该充分认知这种血管变异类型，术中应精细解剖，防止手术操作不当造成的术中出血。.