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KMID : 0978820070100010013
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Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons
2007 Volume.10 No. 1 p.13 ~ p.16
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Analysis of the Location of the Cystic Artery in Laparoscopic Cholecystectomy
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Choi Su-Mun
Song Jun-Ho
Ryu Dong-Hee
Choi Jae-Woon
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Abstract
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Purpose: During laparoscopic cholecystectomy, unexpected bleeding of the cystic artery and its branches may increase the risk of bile duct injuries or conversion of laparoscopic cholecystectomy to open surgery. The aim of this study was to analyze the cystic artery location under the laparoscpic surgical view and to classify the cystic artery variation according to the surgical field findings.
Methods: One hundred two patients who received laparoscopic cholecystectomy at the Department of Surgery, Chungbuk National University Hospital from Jan. 2001 to Feb. 2002 were included in this study. We created four groups for the course of the cystic artery course according to our previous experiences and reviewing the medical literature. The groups are as follows: type A a single cystic artery in Calot’s triangle, type B as more than two cystic arteries in Calot’s triangle, type C as a cystic artery attached to the cystic duct, and type D as a cystic artery lying under the cystic duct. The study was performed prospectively. As determined on the laparoscopic field, the cases of obscure anatomy and blunt clipping of tissues were excluded.
Results: The number of normal anatomical locations of the cystic artery (type A) was 69 (67.7 %). The numbers of variants of the cystic artery’s running course were 19 (18.6 %) of type B, 11 (10.8%) of type C and 2 (2.9%) of type D. There was no difference between males and females.
Conclusion: More than 30% of patients have a variant of the cystic artery’s running course. Dissection of the cystic artery should be performed carefully to achieve successful and safe laparoscopic cholecystectomies.
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KEYWORD
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Cystic artery, Laparoscopic cholecystectomy
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