[Anatomical variants of blood vessels and their surgical challenges related to oncological right hemicolectomy].

Oncological right hemicolectomy requires central ligation of all blood vessels supplying the right colon. This includes the ileocolic, right and middle colic vessels. The vascular variants comprise the prevalence, number, origin as well as the trajectory and involve both the arterial and venous systems. The course of the ileocolic artery ventral or dorsal to the superior mesenteric vein, the frequent absence of the right colic artery, the variable bifurcation of the middle colic artery and the presence of an accessory middle colic artery are of particular relevance. Venous drainage of the ascending colon and right colic flexure is provided by the right/right superior colic veins which frequently drain together with veins from the greater gastric curvature and the pancreatic head into the gastropancreaticocolic trunk (trunk of Henle). The surgical vascular management requires detailed knowledge of these vascular variants. Prevention of vascular complications is best accomplished by a preoperative vascular mapping, e.g., computed tomography (CT) angiography, AMIGO system, 3D reconstruction and the application of the critical view/open book concept.