目的    探讨腹腔镜辅助远端胃切除加D2淋巴结清扫术中胃周血管解剖学特点及临床意义。  方法　按照腹腔镜辅助远端胃癌D2切除术的标准化手术步骤，对100例胃癌患者进行腹腔镜下活体胃周血管解剖学观察。  结果　胃周血管虽然存在于不同的平面内，但血液流动的内在联系性使它们围绕胰腺构成了胃周血管网络。在胰尾上缘的胰前间隙，脾动脉第三段可定位胃网膜左血管。在胰颈下缘的胰后间隙，胰腺钩突及十二指肠水平部前方，可定位肠系膜上静脉。在幽门下方与胰头之前的网膜内可定位胃网膜右血管。在胰体上缘的胰后间隙，可定位腹腔干及其分支。胃胰襞、脾胰襞和肝胰襞是分别定胃左动脉、脾动脉和肝总动脉的解剖标志。  结论　胃周血管多存在变异，腹腔镜远端胃癌D2根治术中应以胰腺为中心标志，同时以胃周主要血管及其分叉为参考，“顺藤摸瓜”解剖定位血管。

Objective　To evaluate vascular anatomy and clinical significance relating to gastric cancer , as well their implications on laparoscopic assisted distal gastrectomy with D2 lymphadenectomy.　Methods　Living observation was carried out in 100 patients diagnosed as distal gastric cancer and undergoing laparoscopic gastrectomy with D2 lymphadenectomy.　Results　Although in different planes, gastric vascular network was consisted surrounding the pancreas, ascribing to intrinsic contact of flowing blood. In pancreatic spaces at superior margin of pancreatic tail left gastrcepiploic vessels were located in the area of the third part of splenic arteries. In retropancreatic space at inferior margin of pancreatic neck，superior mesenteric veins can be found in front of the uncinate process of pancreas and the third part of the duodenum. Right gastroepiploic vessels were located in gastric mesenteries inferior to gastric pylorus. In retropancreatic spaces at superior margin of pancreatic body, gastropancreatic folds, splenopancreatic folds and hepatopancreatic folds were landmarks respectively to locate left gastric arteries, splenic arteries and common hepatic arteries(branches of coeliac trunk). Conclusions　There ares many variations of perigastric vessels, exposed by the guidance of central landmarks of pancreas and concrete landmarks of vessel trunks and their furcations.