Right gastric artery

The right gastric artery (RGA) is a branch of the hepatic arterial system that supplies the lesser curvature of the stomach, running along its inferior portion from right to left where it anastomoses with the left gastric artery, forming part of the rich arterial arcade that encircles the stomach.

Origin and course

The right gastric artery most commonly arises from the proper hepatic artery, with a pooled prevalence of approximately 53.6%. Less frequently, it originates from the left hepatic artery (25.9%), the gastroduodenal artery (8.9%), the common hepatic artery (6.9%), or the right hepatic artery (3.4%). After its origin, the artery courses along the lesser curvature of the stomach within the lesser omentum, supplying the antral and pyloric regions of the stomach before anastomosing with terminal branches of the left gastric artery.

Anatomical relationships and blood supply

The RGA is part of the celiac trunk vascular territory. The celiac artery perfuses the foregut through its three main branches the left gastric, splenic, and common hepatic arteries providing a rich vascular plexus to the stomach, biliary system, duodenum, pancreas, and spleen. The stomach benefits from an extensive anastomotic arterial network: the left and right gastric arteries along the lesser curvature, the left and right gastroepiploic arteries along the greater curvature, and the short gastric arteries to the fundus. This redundant blood supply makes gastric ischemia uncommon.

Clinical significance

The contribution of the RGA to overall gastric blood supply is relatively modest; in the context of gastric tube reconstruction for esophageal surgery, its contribution has been described as negligible compared to the right gastroepiploic artery. Nonetheless, precise knowledge of RGA anatomy and its frequent variations is critical during hepatobiliary, pancreatic, and gastric surgery, as well as during liver transplantation and hepatic artery chemotherapy infusion, to prevent iatrogenic vascular injury. Preoperative imaging with multidetector CT-based 3D angiography can help identify the RGA origin and branching pattern, improving surgical safety.