To evaluate the incidence of double cystic artery: an observational study

Abstract

Aim: The present study was conducted to find out the prevalence of double cystic arteries. Methods: This was a clinical retrospectively study conducted in the Department of General Surgery, AIIMS, Patna, Bihar, India from January 2019 to February 2020. Total 425 patients with symptomatic gallstones with benign gallbladder diseases, gallbladder polyps, previously known gallbladder inflammation, patients without bleeding clotting disorder, being over the age of 18, and patients who can be given general anesthesia induction and  underwent laparoscopic cholecystectomy operation were include in this study. The characteristics and complications of the patients with double cystic artery were recorded and examined. Results: Out of 425 laparoscopic cholecystectomy performed, 100 male and 325 Female. The average age was 23-77(53.21). The double cystic arteries were detected in the operation of 3 males (3%) and 11 female patients (3.38%). The average age of these patients was 51.4±11.97.It was discovered from ultrasound reports that the indication for operation in 2 of the 14 patients with double cystic arteries was gall bladder polyp while it was multiple stones in the gallbladder for the rest of the patients. oral anti-diabetic-regulated diabetes mellitus was detected in 2 female patient, and hypertension was detected in 1 male patient. An epigastric hernia was detected in 2 patients other than gallstones and an epigastric hernia correction was performed simultaneously laparoscopically.3 of the 14 patients (21.43%) with double cystic  arteries were switched from laparoscopic to conventional cholecystectomy due to bleeding during surgery. Bile duct injury was detected postoperatively in 2 male patients with a double cystic artery. The average duration of hospital stay of patients with a double cystic artery is 5.5(4-13) days, and (2.9 days) for patients without a double cystic artery. Conclusion: This study is emphasis the importance of a thorough knowledge of anatomy and recognition of variations of cystic artery are essential prerequisites for safe and uneventful laparoscopic cholecystectomy and can reduce uncontrolled intraoperative hemorrhage and extrahepatic biliary injury.

Key words: Cystic artery, Cholecystectomy, Gallbladder.