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Double Cystic Artery Originating in a Right and a Segment IV Hepatic Artery: A Case Report

Moon Jin Kim1, Young Chul Yoon1

  • 1Department of Surgery, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea.

Journal of Minimally Invasive Surgery
|May 23, 2022
PubMed

Insights

This case report details a rare instance of double cystic arteries originating from the segment IV hepatic artery during laparoscopic cholecystectomy. Unusual falciform ligament attachment may indicate such anatomical variations.

Area of Science:

  • Surgical Anatomy
  • Vascular Anatomy
  • Hepatobiliary Surgery

Background:

  • Anatomical variations of the cystic artery (CA) are common during cholecystectomy.
  • Origin of the CA from the segment IV hepatic artery (HA) is exceptionally rare.

Observation:

  • A case of double CA originating from the right segment IV HA during laparoscopic cholecystectomy (LC) is presented.
  • The falciform ligament was unusually attached to the gallbladder, leading to severe arterial bleeding during dissection.
  • Intraoperative findings revealed a second CA requiring ligation.

Findings:

  • Preoperative computed tomography (CT) confirmed the CA originating from the segment IV HA.
  • The patient experienced no adverse events post-discharge.

Implications:

  • This report highlights a rare CA anatomical variation originating from the segment IV HA.
  • An unusual falciform ligament attachment to the gallbladder may serve as a predictor for aberrant cystic artery anatomy.
  • Awareness of such variations is crucial for preventing intraoperative hemorrhage during LC.

Keywords:
Anatomic variationCholecystectomyCystic artery

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