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Related to cystic artery: Calot's triangle, Right hepatic artery
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The cystic artery (CA) originates from the following sources: right hepatic (63[+ or -]9%), hepatic trunk (26[+ or -]9%), left hepatic (5[+ or -]5%), gastroduodenal (2[+ or -]6%), superior pancreaticoduodenal (0[+ or -]3%), right gastric (0[+ or -]1%), coeliac trunk (0[+ or -]3%) and superior mesenteric (0[+ or -]8%) artery (Anson, 1963).
One patient (10%) required conversion due to difficult dissection in view of acute cholecystitis and the other due to slippage of clip applied to cystic artery.
Third, in order to expose the cystic artery and abnormal anatomy, we can use the same way to flush and aspirate the tissue in the Calot's triangle and identify all the location of main arteries and bile ducts.
The low frequency of this complication, despite the high incidence of acute cholecystitis, may be due to early thrombosis of the cystic artery in the context of severe acute cholecystitis (4).
The intermediate branch emits the cystic artery and branches for the right medial and quadrate lobes.
published articles which contained recommended methods by which the doctor could, and hopefully would, conclusively identify the vital structures, cystic duct, cystic artery in this procedure?
In all those patients, the cystic artery was divided by bipolar cautery and the cystic duct was ligated intracorporeally using non-absorbable suture.
41%) [Figure 1]b, which included typical double trunk type (from the gastroduodenal artery and the proper hepatic artery) in 8 patients, the right hepatic artery in 1 patient and cystic artery in 1 patient.
Surgical intervention consisted of small-bowel adhesiolysis, intra-operative ileoscopy, resection and primary anastomosis of the distal small bowel, stone extraction and cholecystectomy with ligation of the cystic duct and cystic artery.
Complications of this condition include gangrenous cholecystitis, gallbladder perforation, cholecysto-enteric fistula, gallstone ileus (3) and, very rarely, cystic artery pseudoaneurysms (CAP), which can be associated with intra-abdominal and gastrointestinal haemorrhage (4).
the Calot's triangle is unfolded) to conclusively identify the two structures to be cut--the cystic duct and the cystic artery and traced where possible for confirmation.
The reasons for conversion included cystic artery bleeding2, liver bed bleeding1, common hepatic duct injury1, cholecystoduodenal fistula1, severe adhesions caused by tissue inflammation and fibrosis of Calot's triangle1 and cystic duct avulsion1.