The Surgical Anatomy of Gastrocolic Trunk: a Systematic Review, Meta-analysis and Its Significance in Right Colectomy.

Background: The gastrocolic trunk of Henle is a clinically important venous confluence located near the inferior pancreatic border and the right side of the superior mesenteric vein. Its tributary anatomy is variable and may influence surgical dissection during right colectomy, right hemicolectomy, complete mesocolic excision (CME), central vascular ligation (CVL) and D3 lymph node dissection. Objective: This systematic review and meta-analysis aimed to synthesize the anatomical, radiological, and surgical evidence on the prevalence, tributary composition, classification patterns, morphometric features, preoperative recognition and operative relevance of the gastrocolic trunk of Henle in right-sided colon surgery. Methods: A systematic literature search was performed in PubMed, Cochrane Library and ScienceDirect using terms related to the gastrocolic trunk of Henle and its variants. Eligible studies included original anatomical, radiological, and surgically relevant clinical investigations reporting extractable data on GTH/GCT presence, tributaries, drainage patterns, classification, morphometry, imaging recognition, or operative relevance. Random-effects proportion meta-analysis was performed when compatible numerator-denominator data were available. Evidence was stratified into live intraoperative right colectomy/right hemicolectomy studies, preoperative imaging studies, cadaveric studies, and general radiologic anatomy studies. Results: The search identified 188 records. After removal of seven duplicates, 181 records were screened, 21 full-text reports were assessed for eligibility and 15 studies were included in the qualitative synthesis. Eleven studies contributed to quantitative pooled analyses. In live intraoperative right colectomy/right hemicolectomy cohorts, the pooled prevalence of GTH/GCT was 0.9047, with a 95% confidence interval (CI) from 0.7557 to 0.9668 and substantial heterogeneity. In preoperative imaging studies, the pooled detection proportion was 0.8849, with a 95% CI from 0.8079 to 0.9336. Cadaveric studies showed a pooled prevalence of 0.9310, with a 95% CI from 0.8446 to 0.9710. Tributary-specific findings demonstrated substantial variation involving the right colic, superior right colic, middle colic, ileocolic and anterosuperior pancreaticoduodenal veins. Conclusion: The gastrocolic trunk of Henle is a frequent but anatomically variable venous structure with practical relevance to right-sided colon surgery. Its importance lies in its relationship to the superior mesenteric vein, infrapancreatic region and right-colon venous drainage during CME, CVL and D3 lymph node dissection. Current evidence supports careful preoperative and intraoperative assessment of this region, but does not prove that GTH/GCT identification alone improves oncological outcomes. Future studies should use standardized definitions, consistent denominators and prospective reporting of imaging accuracy, operative safety and clinical outcomes.