scholarly journals Retracted: Cadaveric study on variations of the cystic artery in a Zambian population

2018 ◽  
Vol 7 (2) ◽  
pp. 1298-1303
Author(s):  
Isaac Sing`ombe ◽  
Vivienne Nambule ◽  
Fridah Mutalife ◽  
Sikhanyiso Mutemwa ◽  
Elliot Kafumukache ◽  
...  
Keyword(s):  
Gall Bladder ◽  
Hepatic Artery ◽  
Cystic Duct ◽  
Common Knowledge ◽  
Cystic Artery ◽  
University Teaching ◽  
Teaching Hospitals ◽  
Right Hepatic Artery ◽  
Human Cadavers ◽  
The Right

This article has been retracted by the authors. An incorrect dataset was used, therefore the resullts are misleading.The main source of blood supply to the gall bladder is the cystic artery which is a branch of the right hepatic artery. Anatomical variations of the cystic artery are frequent. Thus, careful dissection of the Calot`s triangle is necessary for conventional and laparoscopic cholecystectomy. The knowledge of variations of the origin, course, and length of the cystic artery is important for the surgeon as bleeding from the cystic artery during cholecystectomy can lead to death. Forty-three post-mortem human cadavers at the University Teaching Hospitals, Pathology Department, Lusaka were dissected and examined over a period of five weeks, to establish the origin, length and course of the cystic artery. And to establish the relationship of the cystic artery to the cystic duct. Out of the 43 human cadavers, the cystic artery was found to be originating from the right hepatic artery in 37 cases (86%), from hepatic artery proper in four cases (9.3%), from the left hepatic artery in one case (2.3%) and liver parenchyma in one case (2.3%). In the forty (93%) cadavers dissected, only one cystic artery was identified and in three (7%) others there were two arteries detected. The cystic artery length ranged from 2 – 6 cm (mean 3.53± 0.962 cm). The cystic artery was found to be inside Calot`s triangle in 37 cases (86%) while in four cases (9.3%) it was outside the Calot`s triangle. The cystic artery was found to be passing supero-medial to the cystic duct in 40 cases (93%) while in two cases (4.7%) the cystic artery was passing anterior to the cystic duct and one (2.3%) was unrelated (from the gall bladder bed) to the cystic duct. Demographic characteristic (gender and age) had no statistically significant association to variations of cystic artery (p>0.005). Six (16.2%) of males had variants of cystic artery and no females had variants of the cystic artery. Variations of the cystic artery origin, length, its course through the Calot`s triangle and its relation to the cystic duct are common. Knowledge of these variations is important and helpful in preventing and controlling haemorrhage or avoiding other complications during conventional and laparoscopic cholecystectomy.Keywords: Cystic artery, Cholecystectomy, Calot`s triangle

scholarly journals A cadaveric study on variations of the cystic artery in the department of pathology, at the University Teaching Hospitals, Lusaka, Zambia

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Isaac Sing`ombe ◽  
Vivienne Nambule ◽  
Fridah Mutalife ◽  
Sikhanyiso Mutemwa ◽  
Elliot Kafumukache ◽  
...  
Keyword(s):  
Hepatic Artery ◽  
Cystic Duct ◽  
Cystic Artery ◽  
University Teaching ◽  
Teaching Hospitals ◽  
Right Hepatic Artery ◽  
Human Cadavers ◽  
The Right ◽  
The University ◽  
University Teaching Hospitals

The main source of blood supply to the gall bladder is the cystic artery which is a branch of the right hepatic artery. Anatomical variations of the cystic artery are frequent. Thus, careful dissection of the Calot`s triangle is necessary for conventional and laparoscopic cholecystectomy. The  knowledge of variations of the origin, course, and length of the cystic artery is important for the surgeon as bleeding from the cystic artery during  cholecystectomy can lead to death. Thirty-two post-mortem human cadavers at the University Teaching Hospitals, Pathology Department, Lusaka were dissected and examined over a period of five weeks, to establish the origin, length and course of the cystic artery. And to establish the relationship of the cystic artery to the cystic duct. Out of the 32 human cadavers, the cystic artery was found to be originating from the right hepatic artery in twenty-eight (87.5%), from hepatic artery proper in three (9.4%) and from the left hepatic artery in one (3.1%). In the twenty-nine (90.6%) cadavers dissected, only one cystic artery was identified and in three (9.4%)others there were two arteries detected. The cystic artery length ranged from 2 – 6 cm (mean 3.56± 1.0285 cm). The cystic artery was found to be inside Calot`s triangle in twenty-seven (84.3%) while in three (9.4%) cadavers it was outside the Calot`s triangle. The cystic artery was found to be passing supero-medial to the cystic duct in thirty (93.7%) cadavers while in two (6.3%) the cystic artery was passing anterior to the cystic duct. Demographic characteristic (gender and age) had no statistically significant association to variations of cystic artery (p>0.005). Five (18.5%) of males had variants of cystic artery and no females had variants of the cystic artery. Variations of the cystic artery origin, length, its course through the Calot`s triangle and its relation to the cystic duct are common. Knowledge of these variations is important and helpful in preventing and controlling haemorrhage or avoiding other complications during conventional and laparoscopic cholecystectomy. Key words: Cystic artery, Variations, Cholecystectomy, Calot`s triangle

scholarly journals Duplication of cystic artery: a case report

2015 ◽  
Vol 04 (03) ◽  
pp. 153-154
Author(s):  
Satyajit Mitra ◽  
Alakesh Gogoi
Keyword(s):  
Case Report ◽  
Hepatic Artery ◽  
Cystic Duct ◽  
Surgical Intervention ◽  
Cystic Artery ◽  
Right Hepatic Artery ◽  
Usual Site ◽  
The Right ◽  
Single Branch

AbstractThe cystic artery supplies oxygenated blood to the gallbladder and cystic duct. It usually arises from the right hepatic artery as a single branch, but cases with double cystic artery has also been reported from time to time. During a routine dissection class, the authors found a case in which two cystic arteries originated from the right hepatic artery to supply the two surfaces of gallbladder separately. As the extrahepatic biliary region is the most usual site of surgical intervention, the reporting of any form of variation in this region becomes a necessity.

Anomalous arterial supply to the gallbladder from the superior mesenteric artery: angiography and computed tomography findings in two cases

2008 ◽  
Vol 49 (9) ◽  
pp. 987-990 ◽  
Author(s):  
Y. Katada ◽  
M. Kishino ◽  
K. Ishihara ◽  
T. Takeguchi ◽  
H. Shibuya
Keyword(s):  
Computed Tomography ◽  
Superior Mesenteric Artery ◽  
Hepatic Artery ◽  
Mesenteric Artery ◽  
Cystic Artery ◽  
Arterial Supply ◽  
Hepatic Arteries ◽  
Right Hepatic Artery ◽  
Pancreatic Artery ◽  
The Right

The arterial supply of the gallbladder usually arises from the right hepatic artery. Other origins include the left, proper, and common hepatic arteries. We report cases of the cystic artery arising from the superior mesenteric artery and arising from the dorsal pancreatic artery originating in turn from the superior mesenteric artery, as demonstrated by angiography and computed tomography.

scholarly journals CYSTIC ARTERY VARIATIONS IN LAPAROSCOPIC CHOLECYSTECTOMY

1969 ◽  
Vol 6 (1) ◽  
pp. 714-717
Author(s):  
MUHAMMAD HUSSAIN ◽  
ADNAN BADAR ◽  
MANZOOR ALI ◽  
SHAHID ALAM ◽  
NAIK ZADA ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
General Anesthesia ◽  
Hepatic Artery ◽  
Cystic Duct ◽  
Gold Standard ◽  
Cystic Artery ◽  
Common Hepatic Artery ◽  
Hepatic Parenchyma ◽  
Right Hepatic Artery ◽  
Calot’S Triangle

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.

scholarly journals Caterpillar hump of right hepatic artery: incidence and surgical significance

2012 ◽  
Vol 01 (03) ◽  
pp. 121-124 ◽  
Author(s):  
Devi Jansirani ◽  
N Mugunthan ◽  
Vijisha Phalgunan ◽  
Shiva deep S.
Keyword(s):  
Hepatic Artery ◽  
Undergraduate Students ◽  
Surgical Procedures ◽  
Hepatic Duct ◽  
Cystic Artery ◽  
Common Hepatic Duct ◽  
Right Hepatic Artery ◽  
Calot’S Triangle ◽  
Coeliac Trunk ◽  
The Right

Abstract Background and aims : The right hepatic artery occasionally forms a sinuous tortuousity called as caterpillar hump or Moynihan's hump, which occupies the major portion of Calot's triangle. Due to this variation, inadvertent injury to right hepatic artery may occur during surgical procedures. The aim of the study is to find out the incidence of Caterpillar hump of right hepatic artery in cadavers and to correlate with surgical significance. Materials and methods : Sixty cadavers allotted for the purpose of teaching undergraduate students from the period of 2006 to 2011 were used for this study. Branches of coeliac trunk were traced and right hepatic artery was observed for the presence of caterpillar hump. Results : Caterpillar hump was noted in three out of 60 cadavers (5%). Out of three specimens with caterpillar hump, right hepatic artery passed posterior to common hepatic duct in two specimens and anterior to it in one specimen. The presence of dual loops of right hepatic artery was noted in two specimens and single loop was observed in one specimen. Conclusion: The presence of this variant course of right hepatic artery may lead to the formation of short cystic artery. Thereby, right hepatic artery can be mistaken for cystic artery and may be injured during surgical procedures. The knowledge of caterpillar hump of right hepatic artery is essential for the surgeons to avoid the risk of ischemic necrosis of right lobe of liver.

scholarly journals ANATOMICAL VARIATIONS OF EXTRA HEPATIC BILIARY SYSTEM IN PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY IN CMH & PEMH RAWALPINDI

2021 ◽  
Vol 71 (3) ◽  
pp. 916-19
Author(s):  
Muhammad Ali Muazzam ◽  
Syed Mukarram Hussain ◽  
Muhammad Tanvir Ahmed Qureshi
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Gall Bladder ◽  
Hepatic Artery ◽  
Biliary Tract ◽  
Cystic Duct ◽  
Anatomical Variations ◽  
Cystic Artery ◽  
Military Hospital

Objective: To assess the frequency of anatomical variations of the extra-hepatic biliary tract in patients undergoing laparoscopic cholecystectomy in Combined Military Hospital & Pak Emirates Military Hospital Rawalpindi. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of General Surgery, Combined Military Hospital & Pak Emirates Military Hospital, Rawalpindi, from Mar to Aug 2017. Methodology: A total of 136 patients of either gender with cholelithiasis of more than one month were included. Participants were distributed into equal number of groups for both hospitals by lottery method. All the participants had under gone laparoscopic cholecystectomy by consultant general surgeon or senior registrar under direct supervision. Structures mainly assessed for variations were gall bladder, cystic duct, common hepatic duct, supraduodenal part of common bile duct, cystic artery, and hepatic artery which were characteristically encountered during laparoscopy. Results: Overall Extra hepatic biliary variations were 136 (23%), at Combined Military Hospital 68 (16%) and Pak Emirates Military Hospital 68 (29.4%). Gall bladder anomaly was seen in 3% patients, cystic duct anomaly 4.4%, supraduodenal part of common bile duct anomaly 0.7%, cystic artery anomaly 11% and hepatic artery anomaly was seen in 3.6% patients (p>0.05). Conclusion:  Anatomic variations were found to be not uncommon in our set up. Thus, there is a need for doctors to continuously refresh knowledge of normal anatomy and the variants of biliary tract.

Percutaneous Trans-Hepatic Embolization of an Iatrogenic Extra-Hepatic Pseudoaneurysm of the Right Hepatic Artery in a Patient With Previous Occlusion of the Proper Hepatic Artery: An Endovascular Procedure to Avoid a Difficult Surgical Repair

2021 ◽  
pp. 153857442110225
Author(s):  
Giuseppe S. Gallo ◽  
Roberto Miraglia ◽  
Luigi Maruzzelli ◽  
Francesca Crinò ◽  
Christine Cannataci ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Hepatic Artery ◽  
Surgical Repair ◽  
Endovascular Embolization ◽  
Proper Hepatic Artery ◽  
Ultrasound Guided ◽  
Complete Occlusion ◽  
Right Hepatic Artery ◽  
Ultrasonographic Guidance ◽  
The Right

We report a case of successful percutaneous transhepatic, embolization of an iatrogenic extra-hepatic pseudoaneurysm (PsA) of the right hepatic artery (RHA) under combined fluoroscopic and ultrasonographic guidance. A 73-year-old man underwent percutaneous transhepatic biliary drainage placement in another hospital, complicated by haemobilia and development of a RHA PsA. Endovascular embolization was attempted, resulting in coil embolization of the proper hepatic artery, and persistence of the PsA. At this point, the patient was referred to our hospital. Computed tomography and direct angiography confirmed the iatrogenic extra-hepatic PsA of the RHA, refilled by small collaterals from the accessory left hepatic artery (LHA) and coil occlusion of the proper hepatic artery. Attempted selective catheterization of these vessels was unsuccessful due to the tortuosity and very small caliber of the intra-hepatic collaterals, the latter precluding endovascular treatment of the PsA. Percutaneous trans-hepatic combined fluoroscopic and ultrasound-guided embolization of the PsA was performed with Lipiodol® and cyanoacrylate-based glue (Glubran®2). Real time fluoroscopic images and computed tomography confirmed complete occlusion of the pseudoaneurysm. Surgical repair, although feasible, was considered at high risk. In our patient, we decided to perform a percutaneous trans-hepatic combined fluoroscopic and ultrasound-guided embolization of the PsA using a mix of Lipiodol® and Glubran®2 because of the fast polymerization time of the glue allowing the complete occlusion of the PsA in few seconds, thus eliminating the risk of coil migration, reducing the risk of PsA rupture and avoid a difficult surgical repair.

scholarly journals An Unusual Cause of an Intraperitoneal Bleed: Bleeding Hepatic Artery Pseudoaneurysm Due to an Eroding Cholecystitis

2020 ◽  
Vol 8 ◽  
pp. 232470962098243
Author(s):  
Khalid Sawalha ◽  
Anthony Kunnumpurath ◽  
Ronald McCann
Keyword(s):  
Hepatic Artery ◽  
Open Cholecystectomy ◽  
Artery Aneurysm ◽  
Hemodynamic Instability ◽  
Central Line ◽  
Hepatic Artery Aneurysm ◽  
Artery Pseudoaneurysm ◽  
Right Hepatic Artery ◽  
Abdominal Ct Scan ◽  
The Right

An 80-year-old male patient presented with sepsis secondary to infected central line which was placed for native aortic valve endocarditis. He also had melena and abdominal pain prior to his presentation. Abdominal computed tomography (CT) was done, which showed cholelithiasis. Esophagogastroduodenoscopy was also done with no source of bleeding identified. Later, he developed hemodynamic instability requiring aggressive fluid resuscitation and multiple packed blood cell transfusions. In view of his hemodynamic instability, a repeat abdominal CT scan showed air droplets within the gallbladder pneumobilia, ascites, diverticulosis, and a bleeding infrahepatic hematoma measuring 6 × 10 cm, which was not on his prior scan 2 days prior. A mesenteric arteriogram was performed that identified an aneurysm of the right hepatic artery with no active bleeding; therefore, it was coiled. Due to his continued clinical decompensation, he underwent an urgent open cholecystectomy, in which serosanguineous fluid, cholecystocolic fistula, and old clot related to his previous bleed were encountered. However, control of bleeding was difficult, and the patient expired. We report this case of right hepatic artery aneurysm that we believe its etiology was related to eroding cholecystitis.

scholarly journals Right Hepatic Artery Encircle the Gallbladder: A Case Report

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Hanis M ◽  
Nasser A
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Superior Mesenteric Artery ◽  
Hepatic Artery ◽  
Cystic Duct ◽  
Mesenteric Artery ◽  
Open Cholecystectomy ◽  
Right Hepatic Artery ◽  
Hepatobiliary System ◽  
Duct Ligation ◽  
Cholecystectomy Operation

Detailed knowledge of the vascular anatomy of hepatobiliary system is important for a safe cholecystectomy. We are reporting a case of aberrant type of right hepatic artery originating from superior mesenteric artery and encircles the gallbladder that has been found during laparoscopic cholecystectomy operation. We presented a 39-year-old Malay lady came to International Islamic University Malaysia Medical Centre with features of obstructive jaundice. Ultrasound of hepatobiliary system showed cholelithiasis with choledocholithiasis causing dilatation of the common bile duct. ERCP had been performed and sphincterotomy was done. Patient was planned for laparoscopic cholecystectomy. Intraoperatively, the Calot’s triangle was identified in usual manner. However, the right hepatic artery was identified encircling the gallbladder body anteriorly before entering the liver. The procedure was converted to open cholecystectomy due to anatomical variation via Kocher’s incision. Further identification upon open cholecystectomy revealed right hepatic artery originates from superior mesenteric artery runs anterior to cystic duct and encircles the gallbladder before further branches into right and left lobe of the liver. Right hepatic artery was dissected from the gallbladder and the gallbladder removed after cystic duct ligation and separation from the liver bed. On table cholangiogram showed distal CBD stone which was pushed down to duodenum with forceps? Post-operative was uneventful and patient liver functions improved. Knowledge regarding anatomical structure and variant of hepatic artery as well as cystic artery and cystic duct is important to ensure the inadvertent ligation of right hepatic artery which would leads to hepatic ischemia and necrosis.

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