QS Study

The stomach is a reservoir of food particles, where digestion begins. It is the internal organ in which the major part of the digestion of food occurs, being (in humans and many mammals) a pear-shaped enlargement of the alimentary canal linking the esophagus to the small intestine.

Lymphatic drainage of stomach: This system of the stomach is a multidirectional and complex network composed of lymphatic nodes and vessels. The lymphatic drainage of the stomach can be grouped as following regions:

(i) From the part of the stomach to the left of a vertical line drawn from the cardiac orifice

Lymphatics drain into – pancreaticosplenic nodes.

Few drains into – para – cardiac nodes.

Lymph node metastasis is the most important prognostic factor in curable gastric cancer and lymph node dissection is one of the main areas of surgical research in gastric cancer.

(ii) From the upper 2/3 rd of the right part of the stomach – Drain into – left gastric lymph nodes.

The left gastric arterial nodal group, which follows the left gastric artery and drain into the celiac nodes. They drain the lesser curvature of the stomach to the left.

(iii) From the lower 1/3 rd of the right part – Lymphatics drain into – Right gastro-epiploic nodes.

Efferents from these nodes drain into – Pyloric group. Pyloric nodes which drain the pyloric part of the stomach to the hepatic, pyloric and left gastric nodes.

Lymphatics drain in three directions:

(a) Into hepatic group,

(b) Into pyloric group,

(c) Into left gastric lymph nodes.

Efferent’s from these nodes drain into – coeliac nodes. From these nodes, they pass into the intestinal lymph trunks, which then enter the cisterna chyli or the abdominal confluence of lymph trunks. The cisterna chyli drains into the thoracic duct.