Related Experiment Video
Updated: May 17, 2025
The Role of Indocyanine Green Fluorescence in Complex Laparoscopic Cholecystectomy Navigation
Published on: January 31, 2025
ANATOMIC VARIATIONS OF THE CYSTIC ARTERY DURING CHOLECYSTECTOMIES: IS IT IMPORTANT FOR THE SURGEON TO KNOW?
João Alfredo Schiewe1, Livia Hoyer Garcia Miranda1, Renata Marino Romano1
1Universidade Estadual do Centro-Oeste, Department of Medicine - Guarapuava (PR), Brazil.
Insights
Cystic artery variations are common during cholecystectomies, with many cases showing different origins or gallbladder irrigation patterns. Surgeons need anatomical knowledge of these variations to ensure safe procedures and prevent injuries.
Area of Science:
- Surgical Anatomy
- Vascular Anatomy
- Gastrointestinal Surgery
Background:
- Knowledge of cystic artery anatomy and variations is crucial for safe cholecystectomies.
- The cystic artery typically originates from the right hepatic artery and supplies the gallbladder.
- Common variations involve its position, size, and relationship with surrounding structures.
Purpose of the Study:
- To review the literature on cystic artery variations and their prevalence during cholecystectomies.
- To highlight the importance of anatomical knowledge for surgical safety.
Main Methods:
- Literature search of PubMed and SciELO databases.
- Used keywords: anatomic variation, cholecystectomy, and cystic artery.
- Selected articles based on relevance to cystic artery variations in cholecystectomy.
Main Results:
- The standard anatomical pattern of the cystic artery was observed in 54.5% of studies.
- Variations in origin were reported in 63.6%, and double gallbladder irrigation in 59.1%.
- Other variations included position relative to ducts (36.4%), location outside Calot's triangle (36.4%), and short length (13.6%).
Conclusions:
- Cystic artery variations are frequent and commonly reported in surgical literature.
- Familiarity with these anatomical variations is essential for surgeons to minimize vascular and biliary injuries during cholecystectomy.
- Enhanced anatomical understanding contributes to improved patient safety in cholecystectomy procedures.
Background:
Knowledge of the cystic artery and its variations is essential to perform safe cholecystectomies. The cystic artery originates from the right hepatic artery, passing posterior to the common hepatic duct, anterior to the cystic duct, and branching into two branches at the neck of the gallbladder. However, variations in position, size, and relationship with adjacent structures are common.
Aims:
This article presents a literature review regarding cystic artery variations and their frequency during cholecystectomies.
Methods:
The articles selected for this review were chosen from the PubMed and SciELO databases. The standardized descriptors used were anatomic variation and cholecystectomy. These were chosen using the "Medical Subject Headings" and combined with the Boolean operator AND and the non-standard descriptor cystic artery.
Results:
It was found in 54.5% of the studies that the anatomical pattern of the cystic artery was the most frequent type. A different origin from the standard was cited in 63.6% of the articles. Double irrigation of the gallbladder was found in 59.1%. In 36.4%, the cystic artery was anterior to the common hepatic duct or the cystic duct. Cystic arteries outside Calot's triangle were found in 36.4%. Short cystic arteries were found in 13.6%. The absence or non-identification of the artery was reported in 9.1%.
Conclusions:
Variations of the cystic artery are common and are frequently reported. One aspect of a safe cholecystectomy is anatomical knowledge and its possible variations. Thus, surgeons must be familiar with this point in order to reduce vascular and biliary injuries.
