Publication:

Prevalence of anatomical variations of cystic artery during laparoscopic cholecystectomy

Background The objective of the present study was to observe prevalence of anatomical variations of cystic artery in patients with the aim of avoiding accidental damage during laparoscopic cholecystectomy.

Methods Patients (n=600) who underwent elective laparoscopic cholecystectomy after written and informed consent between October 2015 to October 2018 at Teerthankar Mahaveer Medical College and Research Centre, Moradabad were followed prospectively. Laparoscopic cholecystectomies were performed with 04 port technique with patients under anesthesia. Cystic artery’s anatomical variations with reference to triangle of calot in each patient undergoing the surgery was visualized through laparoscope and recorded.

Results Several anatomic variations of cystic artery were seen under laparoscope. Our experience with 600 cholecystectomies revealed that in majority of patients (85.67%; n=514), cystic artery was present in the boundaries of triangle of Calot, followed by outside the triangle of Calot seen in 13.33% (n=80) patients, while compound type was found in only 1% patients (n=6).

Conclusions Variations in the anatomy of cystic artery with reference to triangle of calot is seen very often. Knowledge of these variations helps in prevention of accidental hemorrhage during laparoscopic cholecystectomy. Cystic artery is present inside the triangle of calot in majority of cases. We found that classification suggested by You-Ming et al is very useful.