DOI: http://dx.doi.org/10.18203/2349-2902.isj20203499

Incidence of double cystic artery: a clinical study

Tamer Akay, Metin Leblebici

Abstract


Background: A successful laparoscopic cholecystectomy is associated with the knowledge about anatomic structures and the congenital anomaly of the biliary tract. The aim of this study was to become familiar with vascular variations in laparoscopic cholecystectomy.

Methods: This was a retrospective clinical study. The files of patients who underwent laparoscopic cholecystectomy due to benign gallbladder diseases were analyzed. The characteristics and complications of the patients with double cystic artery were recorded and examined.

Results: A total of 360 patients, 76 males and 284 females were included in the study. The mean age was 51.2 (25-81). When the files of the patients were examined, it was found that double cystic arteries were detected during the operation in two male (2.63%) and nine female patients (3.16%). Gall bladder polyp was found as an indication for operation in one of 11 patients, while multiple gallbladder stones were found as an indication for operation in the other patients. The laparoscopic cholecystectomy was converted to conventional cholecystectomy in two from 11 patients (18.1%) with double cystic arteries due to bleeding. The mean duration of hospital stay in the patients with double cystic artery is 5.2 (3-11) days, and (2.7 days) longer compared to the patients without a double cystic artery.

Conclusions: Cystic artery variations and other variations can coexist. Awareness of cystic artery variations can reduce the possibility of uncontrolled intraoperative bleeding, extrahepatic biliary injury, and switching to conventional cholecystectomy.

 


Keywords


Cholecystectomy, Cystic artery, Variation

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References


Sidana K, Jadav HR, Patel BG. The prevalence of double cystic artery: a cadaveric study. GCSMC J Med Sci. 2016;5(2):116-9.

Li LJ, Zheng XM, Jiang DZ, Zhang W, Shen HL, Shan CX, et al. Progress in laparoscopic anatomy research: A review of the Chinese literature. World J Gastroenterol. 2010;16(19):2341-7.

Veena P, Subhash LP, Anupama D, Nagaraj DN. Dual cystic artery- a case report. Anatomica Karnataka. 2011;5(2):52-4.

Eyni H, Pasbakhsh P, Azimi A, Fard SB. Case report: variation of the gallbladder vasculature including double cystic arteries. Anatom Sci. 2015;12(1):51-5.

Chen TH, Shyu JF, Chen CH, Ma KH, Wu CW, Lui WY, et al. Variations of the cystic artery in Chinese adults. Surg Laparosc Endosc Percutan Tech. 2000;10(3):154-7.

Hlaing KP, Thwin S, Shwe N. Unique origin of the cystic artery. Singapore Med J. 2011;52(12):263.

Hugh TB, Kelly MD, Li B. Laparoscopic anatomy of the cystic artery. Am J Surg. 1992;163:593-5.

Singh K, Ohri A. Anatomic landmarks: their usefulness in safe laparoscopic cholecystectomy. Surg Endosc. 2006;20:1754-8.

Dandekar U, Dandekar K, Chavan S. Right hepatic artery: a cadaver investigation and its clinical significance. Anat Res Int. 2015; 2015:412595.

Ding YM, Wang B, Wang WX, Wang P, Yan JS. New classification of the anatomic variations of the cystic artery during laparoscopic cholecystectomy. World J Gastroenterol. 2007;13(42):5629-34.

Suzuki M, Akaishi S, Rikiyama T, Naitoh T, Rahman MM, Matsuno S. Laparoscopic cholecystectomy, Calot’s triangle, and variations in cystic arterial supply. Surg Endosc. 2000;14(2):141-4.

Zubair M, Habib L, Mirza RM, Cnanna MA, Yousuf M, Quraishy MS. anatomical variations of cystic artery: telescopic facts. Med J Malaysia. 2012;67(5):494-6.

Talpur KA, Laghari AA, Yousfani SA, Malik AM, Memon AI, Khan SA. Anatomical variations and congenital anomalies of extra hepatic biliary system encountered during laparoscopic cholecystectomy. J Pak Med Assoc. 2010;60(2):89-93.

Saidi H, Karanja TM, Ogengo JA. Variant anatomy of the cystic artery in adult Kenyans. Clin Anat. 2007;20(8):943-5.

Futara G, Ali A, Kinfu Y. Variations of the hepatic and cystic arteries among Ethiopians. Ethiopian Med J. 2001;39(2):133-42.

Balija M, Huis M, Nikolic V, Stulhofer M. Laparoscopic visualization of the cystic artery anatomy. World J Surg. 1999;23(7):703-7.

Mlakar B, Gadzijev EM, Ravnik D, Hribernik M. Anatomical variations of the cystic artery. Eur J Morphol. 2003;41(1):31-4.

Sarkar AK, Roy TS. Anatomy of the cystic artery arising from the gastroduodenal artery and its choledochal branch- a case report. J Anat. 2000;197(3):503-6.

Bincy MG, Somayaji SN. Multiple variations of the subhepatic hepatobiliary vasculature porta. Int J Anatomy. 2010;3:39-40.

Loukas M, Fergurson A, Louis RG Jr, Colborn GL. Multiple variations of the hepatobiliary vasculature including double cystic arteries, accessory left hepatic artery and hepatosplenic trunk: a case report. Surgical Radiologic Anatomy. 2006;28(5):525-8.

Polguj M, Podgórski M, Hogendorf P, Topol M. Variations of the hepatobiliary vasculature including coexistence of accessory right hepatic artery with unusually arising double cystic arteries: case report and literature review. Anat Sci Int. 2014;89(3):195-8.

Fachinelli A, Trindade MR, Fachinelli FA. Elastic fibers in the anterior abdominal wall. Hernia. 2011;15(4):409-15.

Sorensen LT. Effect of lifestyle, gender and age on collagen formation and degradation. Hernia. 2006;10(6):456-61.