目的:探讨腹腔镜辅助远端胃癌D2根治术的临床疗效及术中胃周血管解剖特点。方法:回顾2011年6月—2013年6月45例腹腔镜下远端胃癌D2根治术的胃癌患者,对临床疗效及术中胃周血管解剖特点进行分析。结果:45例患者中43例完成腹腔镜手术,平均手术时间(178.75±44.32)min,术中出血(100±50)mL,清扫淋巴结(27.55±7.52)枚,术后胃肠功能恢复时间(3.2±1.1)d,下床活动时间(2.5±1.0)d,住院时间(11.5±7.5)d,术后并发症发生率为9.3%;胃周血管解剖中,胃网膜左血管主要起自脾动脉第3段,位于在胰尾上缘的胰前间隙。肠系膜上血管主要在胰颈下缘的胰后间隙,胰腺钩突及十二指肠水平部前方。胃网膜右血管主要在幽门下方与胰头之前的网膜内,但变异较大。腹腔干及其分支主要在胰体上缘的胰后间隙。胃胰襞、脾胰襞和肝胰襞是分别定位胃左动脉、脾动脉和肝总动脉的解剖标志。结论:腹腔镜远端胃癌D2根治术是安全可行的,掌握好胃周血管解剖及定位是手术成功的关键。 Objective: To investigate the clinical efficacy of laparoscopic-assisted D2 distal radical gastrectomy and its intra-gastric vascular anatomy. Methods: From June 2011 to June 2013,45 cases of gastric cancer with D2 radical mastectomy for distal gastric cancer undergoing laparoscopic resection were reviewed. The clinical curative effect and the anatomic characteristics of intraoperative peripancreatic vascular anatomy were analyzed. Results: Among the 45 patients, 43 patients underwent laparoscopic surgery with mean operative time (178.75 ± 44.32) min, intraoperative bleeding (100 ± 50) mL and dissected lymph nodes (27.55 ± 7.52), postoperative gastrointestinal function recovery time 3.2 ± 1.1) d, time to bed activity (2.5 ± 1.0) d, hospital stay (11.5 ± 7.5) days, and postoperative complication rate was 9.3%. In the perivascular vascular anatomy, The third paragraph of the splenic artery, located in the pancreatic tail edge of the anterior pancreatic clearance. The superior mesenteric vessels mainly in the pancreas after the pancreatic lower edge of the pancreas after the pancreas, uncinate process and front of the duodenum level. Right gastric blood vessels in the pylorus below the pylorus and pancreatic head before the omentum, but greater variation. The celiac trunk and its branches are mainly located in the pancreas behind the pancreas. Gastric pancreas, spleen and pancreas and liver and pancreas are the anatomical landmarks of the left gastric artery, splenic artery and common hepatic artery, respectively. Conclusions: D2 laparoscopic radical gastrectomy is safe and feasible. To grasp the anatomy and location of perivascular blood vessels is the key to successful operation.