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An aberrant left gastric vein ( ALGV ) directly entering the lateral segment of the liver is a rare variation in the portal vein system, whereas an aberrant left hepatic artery ( ALHA ) arising from the left gastric artery is observed relatively frequently. Here we report a case in which both  ALGV  and  ALHA  were encountered before laparoscopic distal gastrectomy with curative lymphadenectomy for gastric cancer. We accurately diagnosed these vessel anomalies preoperatively on abdominal contrast‐enhanced CT. During surgery, we divided the  ALGV  at the point of entry to the liver and preserved the  ALHA  by dividing the branches toward the stomach, in consideration of curability and safety. The postoperative course was uneventful overall, although temporary mild liver dysfunction was observed. This case highlights the importance of preoperative evaluation and preparation in a rare case of concurrent  ALGV  and  ALHA .

asian journal of endoscopic surgery

Strategic approach to concurrent aberrant left gastric vein and aberrant left hepatic artery in laparoscopic distal gastrectomy for early gastric cancer: A case report