Lymphatics of the stomach, liver and gallbladder
After completing this study unit you will be able to:
- Identify and name the main groups of lymph nodes draining the stomach, liver and gallbladder.
- Describe the typical drainage pattern of lymph from these organs.
The lymphatic drainage of the stomach is somewhat variable between individuals however several major lymph nodes are generally involved. These are the:
- juxtacardial nodes, located in the region of the cardia of the stomach,
- right/left gastric nodes, short gastric nodes, right/left gastroomental (a.k.a. gastroepiploic) nodes (all of which are related to the arteries of the same names),
- pyloric nodes (made up of the supra-, sub- and retropyloric groups), related to the pylorus of the stomach.
The lymphatic drainage of the liver is elaborate, but can be split into superficial and deep pathways:
- The superficial pathway transports lymph via channels in the subserosal areolar tissue which envelopes the liver. The anterior and inferior surfaces largely drain to hepatic nodes, while lymph from other surfaces is mainly received by various node groups of the inferior mediastinum or the celiac/superior mesenteric nodes.
- The deep pathway consists of hepatic lymph vessels which follow branches of the hepatic arteries and portal vein and flow towards the hepatic nodes at the hilum of the liver. Other lymphatic vessels course along the hepatic veins which exit via the bare area of the liver; these are received by the right lumbar (a.k.a. caval) nodes or inferior diaphragmatic nodes.
Lymph drained from the gallbladder is mainly received either directly by hepatic nodes or first via a cystic lymph node.
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Explore each structure you have learned about in the gallery below.
Cardia: Juxtacardial nodes
Fundus: Short gastric nodes
Lesser curvature: Right/left gastric nodes
Greater curvature: Right/left gastroomental nodes
Pyloric part: Pyloric nodes (suprapyloric, retropyloric, subpyloric nodes)
Drain to celiac nodes → intestinal lymphatic trunk → cisterna chyli → thoracic duct
Anterior surface → hepatic nodes
Inferior surface → hepatic nodes (or directly to lumbar nodes)
Superior surface → hepatic nodes/parasternal/pericardiac nodes
Posterior surface → celiac/superior mesenteric or posterior mediastinal nodes
Most lymph drains to hepatic nodes → celiac nodes
Additional vessels exit via bare area of liver → posterior mediastinal/ right lumbar nodes
|Superior aspect → cystic node or directly to hepatic nodes
Inferior aspect → cystic node, posterior pancreaticoduodenal nodes or preaortic nodes