Safety of Laparoscopic Cholecystectomy in Double Cystic Artery Variation.

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Akay T., Leblebici İ. M.

3. International Health Science And Life Congress, Burdur, Türkiye, 4 - 06 Haziran 2020, ss.264-267

  • Basıldığı Şehir: Burdur
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayıları: ss.264-267


Laparoscopic cholecystectomy is the preferred surgical method for symptomatic gallstone disease and

other benign gallbladder diseases Success in laparoscopic cholecystectomy is related to the level of

knowledge about the anatomical structures and congenital anomalies of the biliary tree. In the

literature, during laparoscopic cholecystectomy, 1.9% of patients switched from laparoscopic surgery

to conventional cholecystectomy due to vascular damage. Mortality was observed in 0.02% of cases.

Anatomical landmarks in laparoscopic cholecystectomy have been reported especially as Rouviere’s

sulcus, cystic lymph nodes and arteries. The cystic artery usually originates from the hepatic artery in

1 to 3 branches and is located in the Calot triangle. In 75-80% of reported cases, it passes through the

hepatobiliary triangle or the triangle of Calot. On approaching the gallbladder, the cystic artery

divides into superficial and deep branches. The superficial branch travels below the gallbladder

corpus and the deep branch above the gallbladder. These branches make anostomoses in the

gallbladder parenchyma. The incidence of double cystic artery ranges from 2 to 25-%, but its

occurrence varies among different populations. This situation is associated with the congenital

absence of the deep branch of the cystic artery as a result of developmental changes in the primitive

ventral splanchnic arteries. Recognition of cystic artery anatomy and variations reduces the likelihood

of intraoperative bleeding, biliary injury, and conversion to conventional cholecystectomy.

Consequently, recognition of cystic artery anatomy and variations may reduce the possibility of

uncontrolled intraoperative bleeding and extrahepatic biliary injury and the conversion to

conventional cholecystectomy.

Keywords: Cholecystectomy, Cystic artery, Variation.