A study to evaluate morphological variations of the cystic artery to improve surgical safety

Abstract

Background: Cystic artery is a key anatomical structure usually isolated and ligated during conventional cholecystectomy or laparoscopic cholecystectomy. The present study was conducted to evaluate morphological variations of the cystic artery to improve surgical safety. Materials & Methods: 40 human liver specimens with intact gallbladder and extrahepatic duct in the regular dissection were fixed in 10% formalin and were finely dissected. The specimens were observed for parameters like the origin of the CA, its length and diameter, mode and level of termination, and its relation to the Calot’s triangle, and the variations were noted, photographed, and studied. Results: Cystic artery of origin was right hepatic artery in 84%, persistent hypoglossal artery in 2%, left hepatic artery in 1%, gastroduodenal artery in 2%, common hepatic artery in 1% and aberrant right hepatic artery in 10%. The vascular relations of cystic artery was anterior to cystic duct in 4%, posterior to cystic duct in 6%, anterior to CHD in 2%, posterior to CHD in 12%, anterior to CBD in 1% and no relation in 75%. Site of origin of CA was inside Calot’s triangle in 70% and outside calot’s triangle in 30%. The difference was significant (P< 0.05). Conclusion: In maximum cases cystic artery of origin was right hepatic artery and in maximum cases its origin was in calot’s triangle.