Abstract
STUDY ON THE ANATOMIC VARIATIONS OF CYSTIC ARTERY DURING LAPAROSCOPIC CHOLECYSTECTOMY AND ITS CLASSIFICATION

Bagavath Ponkailasm, Selwin J. Kumar and Prof. J. A. Jayalal*

ABSTRACT

The cystic artery is the key structure to be clipped or ligated during laparoscopic or conventional cholecystectomy. The possible complications like hemorrhage or hepatobiliary tract injuries are always centred on the process of search, dissection, and clipping or ligation of the cystic artery, many a time because of possibility of variations in its course and relations to the biliary ducts. This descriptive study was carried out to document the normal anatomy and different variations of the cystic artery with a objective to contribute to improve surgical safety. This study was conducted in a Government teaching hospital on 100 patients undergoing laparoscopic chole cystectomy. Based on our laparoscopic dissection of the calots triangle on this 100 non-emergency patients, 32 men and 68 women, who underwent laparoscopic cholecystectomy for different gallbladder diseases, including 92 with cholecystitis and gallstones, and 8 with gallbladder polyps had the mean age of 38.5 years, we observed and classified cystic artery anatomy into three groups. Group one comprises two subtypes of having cystic artery in calot‚ÄĚs triangle as single or double cystic artery.85 patients were had group one with single cystic artery in 3 patients and double cystic artery in 12 patients. Group 2 comprises four types and termed as outside calots triangle group had 12 cases with 7 cystic artery arising from gastroduodenal artery, 3 from aberrant right hepatic artery and one each from left hepatic and liver parenchyma.Group 3 was a mixed group and had present in three patients. The knowledge of such variations and its awareness will decrease morbidity and help to keep away from a number of surgical complications during cholecystectomy.

Keywords: Cystic artery, hcholecystectomy, anatomy. Haemorrhage. Calots triangle.


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