CYSTIC ARTERY VARIATIONS IN LAPAROSCOPIC CHOLECYSTECTOMY

BACKGROUND: Lap cholecystectomy is gold standard for cholelithiasis. Earlier the incidence ofmorbidity and mortality was higher. Later on with the understanding of anatomy and fine techniquesboth morbidity and mortality decreased. Understanding of the anatomy of calot’s triangle reduces thecomplications of the procedure.OBJECTIVE: To study the pattern of variations in cystic artery and comparison with Caucasians.MATERIAL AND METHODS: All laparoscopic cholecystectomies performed in Shah MedicalCentre,over a period of 1 year from January 2013 to December 2013,in whom detailed anatomy ofcalot’s triangle was clearly displayed were included in the study. Those laparoscopic cholecystectomiesin whom the detailed anatomy was not clear were excluded from the study.Laparoscopic cholecystectomies were performed under general anesthesia. The anatomy of cystic arteryand its branches were identified, and it was also correlated in relation to cystic duct and common hepaticduct.We performed 240 lap cholecystectomies over a period of 1 year from January 2013 to December 2013.RESULTS: The pattern of cystic artery was studied in 240 laparoscopic procedures. Origin of cysticartery from right hepatic artery was observed in 82% cases. Double cystic arteries were observed in 8%cases. Common hepatic artery gave rise to 6% cystic arteries. Cystic arteries originated fromgastroduodenal artery in 3% cases. Hepatic parenchyma gave rise to 2% cases.CONCLUSION: Percentage of variations in cystic artery as compared to Caucasians are not different inour study.These variations should be kept in mind to reduce complications.KEYWORDS: laparoscopic cholecystectomy, calot’s triangle, hepatic artery, cystic artery.