Rare case of accessory cystic artery treated with laparoscopic cholecystectomy

Vinayak Venu; Basant Rohil; Pramod D. Nichat; Suresh Mahankudo; Ashis Majhi; Salman Malik; Tanuja Peddi

doi:10.18203/2349-2902.isj20243992

Authors

Vinayak Venu Department of Surgery, Grant Government Medical College and Sir JJ Groups of Hospitals, Mumbai, Maharashtra, India
Basant Rohil Department of Surgery, Grant Government Medical College and Sir JJ Groups of Hospitals, Mumbai, Maharashtra, India
Pramod D. Nichat Department of Surgery, Grant Government Medical College and Sir JJ Groups of Hospitals, Mumbai, Maharashtra, India
Suresh Mahankudo Department of Surgery, Grant Government Medical College and Sir JJ Groups of Hospitals, Mumbai, Maharashtra, India
Ashis Majhi Department of Surgery, Grant Government Medical College and Sir JJ Groups of Hospitals, Mumbai, Maharashtra, India
Salman Malik Department of Surgery, Grant Government Medical College and Sir JJ Groups of Hospitals, Mumbai, Maharashtra, India
Tanuja Peddi Department of Surgery, Grant Government Medical College and Sir JJ Groups of Hospitals, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-2902.isj20243992

Keywords:

Gall bladder diseases, Challenge anatomy, Lap chole, Minimal access surgery, Hepatobiliary anatomy

Abstract

Anomalies of the cystic artery are of significant clinical importance during laparoscopic cholecystectomy, with accessory cystic arteries posing a challenge for surgeons due to increased risk of vascular injury and hemorrhage. This case report describes a 45-year-old female patient who underwent laparoscopic cholecystectomy for symptomatic cholelithiasis, during which an accessory cystic artery was identified. Careful dissection and precise intraoperative management allowed for the successful identification and ligation of both the main and accessory cystic arteries, preventing intraoperative complications. The patient had an uneventful recovery and was discharged on postoperative day two. This case emphasizes the importance of preoperative awareness of vascular variations and highlights the need for meticulous surgical technique to avoid potential complications in patients with accessory cystic arteries.

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References

Standring S. Gray’s Anatomy: The Anatomical Basis of Clinical Practice. 40th Edition. Churchill Livingstone/Elsevier, New York, NY, USA. 2008.

Hollinshead WH. Anatomy for Surgeons. The Thorax, Abdomen and Pelvis. 2nd Edition. Harper and Row, New York, NY, USA. 1971.

Michels NA. The hepatic, cystic and retroduodenal arteries and their relations to the biliary ducts: with samples of the entire celiacal blood supply. Ann Surg. 1951;133(4):503-24. DOI: https://doi.org/10.1097/00000658-195104000-00009

Rocko JM, Swan KG, Di Gioia JM. Calot’s triangle revisited. Surg Gynecol Obstet. 1981;153(3):410-4.

Hugh TB, Kelly MD, Li B. Laparoscopic anatomy of the cystic artery. Am J Surg. 1992;163(6):593-5. DOI: https://doi.org/10.1016/0002-9610(92)90564-8

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. DOI: https://doi.org/10.1046/j.1469-7580.2000.19730503.x

Anson BH. The aortic arch and its branches. Cardiology- Volume 1. In: Luisada A, editor. New York: McGraw-Hill. 1963;119.

Michels NA. Blood supply and anatomy of the upper abdominal organs with descriptive atlas. Philadelphia: Lippincot company. 1955;155-75.

Harris HW, Pellegrini CA. Surgical Disease of the Biliary Tract and Pancreas- Multidisciplinary Management Year Book. In: Braasch JW, Tompkins RK, editors. St Louis: Mosby. 1994;130-2.

Aristotle S. Variations in origin and course of cystic artery and its relations to Calot’s triangle with its clinical implications. OA Anatomy. 2014;2:2-17.

Flinsinski P, Szpinda M, Flisinski M. The cystic artery in human fetuses Folia Morphol. 2004;63(1):47-50.

Hollinshed WH. The Liver and Gall bladder. Anatomy for surgeons – Volume 2. The thorax, abdomen and pelvis. New York: Harper and Brothers. 1956;2:346-58.

Vishnumaya G, Potu BK, Gorantia VR, Thejodhar P. Anomalous origin of the cystic artery from the gastroduodenal artery- A case report. Int J Morphol. 2008;26(1):75-6. DOI: https://doi.org/10.4067/S0717-95022008000100012