Arteria cystica anomalies in laparoscopic cholecystectomy

Abstract

Aim: In laparoscopic surgery, knowing the anatomic variations helps being ready for any possibilities. In this study, the positions of the Calot`s triangle, and a. cystica and ductus cysticus in relation to each other were eval­uated in people from the area who underwent laparoscopic cholecystectomy, and frequency of variation was re­viewed.Materials and Methods: In our study, the operation images of 100 patients who underwent laparoscopic cholecys­tectomy in the General Surgery Clinic at the Medical Faculty of Trakya University were monitored and the anato­my of Calot`s triangle was evaluated.Results: In 82% of our cases, the a. cystica was observed as a single branch in the Calot`s triangle, whereas two aa. cysticae were clipped in 12% of the cases. In 2 cases, a. hepatica dextra in the Calot`s triangle was observed very close to the gallbladder serosa, and there was a very short a. cystica. In one case, a. cystica first passed to the pos­terior aspect of ductus cysticus and formed a curve at the lower portion of ductus cysticus, then turned to the anterior aspect of the duct, and continued to the gallbladder serosa from the neck part. In 3 cases in this study, a. cys­tica moved in a caudal direction and was parallel to ductus cysticus, then entered the bladder.Conclusion: In brief, the anatomy of the Calot`s triangle, which acts as a key point in laparoscopic cholecystecto­my, varies much. A good understanding of the anomalies of a. cystica in laparoscopic cholecystectomies is impor­tant in order to prevent possible complications.