ANATOMIC VARIATIONS OF THE CYSTIC ARTERY DURING CHOLECYSTECTOMIES: IS IT IMPORTANT FOR THE SURGEON TO KNOW?

João Alfredo Schiewe, Livia Hoyer Garcia Miranda, Renata Marino Romano, Marco Aurelio Romano
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Abstract

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.

胆囊切除术中囊性动脉的解剖变化:外科医生知道这一点重要吗?
背景:了解胆囊动脉及其变异是进行安全胆囊切除术的必要条件。囊性动脉起源于肝右动脉,经肝总管后,囊性管前,在胆囊颈处分成两支。然而,位置、大小和与邻近结构的关系的变化是常见的。目的:本文对胆囊切除术中胆囊动脉变异及其发生频率的文献进行综述。方法:本综述选取的文章来自PubMed和SciELO数据库。使用的标准化描述符是解剖变异和胆囊切除术。这些是使用“医学主题标题”选择的,并与布尔运算符and和非标准描述符囊性动脉相结合。结果:在54.5%的研究中,囊性动脉是最常见的解剖类型。63.6%的文章引用了与标准不同的来源。胆囊二次冲洗占59.1%。36.4%的患者囊性动脉位于肝总管或囊性管前。卡洛三角外囊性动脉占36.4%。短囊性动脉占13.6%。9.1%的人报告动脉缺失或无法识别。结论:囊性动脉的变异是常见的,并且经常被报道。安全胆囊切除术的一个方面是解剖学知识及其可能的变化。因此,外科医生必须熟悉这一点,以减少血管和胆道损伤。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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