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Assessment and classification of cystic arteries with 64-detector row computed tomography before laparoscopic cholecystectomy

Surgical and Radiologic Anatomy volume 37, pages 1027–1034 (2015)Cite this article

Abstract

Purpose

Major complications of laparoscopic cholecystectomy are bleeding and bile duct injury, and it is necessary to clearly identify structures endoscopically to keep bleeding and injury from occurring. The aim of this study was to depict the anatomical variation between cystic arteries among patients using 64-detector row spiral computed tomography (CT) prior to laparoscopic cholecystectomy.

Methods

A total of 78 patients (31 men, 47 women) who underwent cholecystectomy were examined preoperatively using 64-detector row spiral CT between April 2012 and June 2013. The origin and number of cystic arteries and their relationship with the Calot triangle was evaluated by two independent observers. CT images were compared with laparoscopic cholecystectomy results.

Results

The cystic arteries were delineated by CT in 73 of the 78 patients. The relationship between the cystic arteries and the Calot triangle was identified in 71 of the 78 patients. One cystic artery was found in 53 (73 %) of the 73 patients, while two cystic arteries were found in 20 (27 %) of the patients. A total of 55 (60 %) of the 91 cystic arteries passed through the Calot triangle. The remaining 36 cystic arteries (40 %) passed anterior, posterior, or inferior to the cystic duct. The relationship between the cystic arteries and the Calot triangle detected by CT was in agreement with the surgical records for all patients.

Conclusion

The configuration of the cystic arteries and their relationship with the Calot triangle can be identified using 64-detector row CT before laparoscopic cholecystectomy.

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Acknowledgments

This research was financially supported by the Fund of Leading Medical Cooperation Project of Shanghai Songjiang District (2011LX06). The authors would like to thank Yanbing Chen and Yuansheng Tao for the surgical technique support and Editage (http://www.editage.com/) for English language editing.

Conflict of interest

None.

Author information

Affiliations

  1. Department of Radiology, Shanghai Songjiang Central Hospital, Shanghai, 201699, People’s Republic of China

    Jindong Xia, Yao He & Jiao Qu

  2. Department of Radiology, School of Medicine, Shanghai First People’s Hospital, Shanghai Jiaotong University, Shanghai, 200080, People’s Republic of China

    Zaixian Zhang & Jia Yang

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  1. Jindong Xia
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  2. Zaixian Zhang
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  3. Yao He
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  4. Jiao Qu
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  5. Jia Yang
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Correspondence to Jia Yang.

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Xia, J., Zhang, Z., He, Y. et al. Assessment and classification of cystic arteries with 64-detector row computed tomography before laparoscopic cholecystectomy. Surg Radiol Anat 37, 1027–1034 (2015). https://doi.org/10.1007/s00276-015-1479-7

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  • DOI: https://doi.org/10.1007/s00276-015-1479-7

Keywords

  • Calot triangle
  • Cystic artery
  • Laparoscopic cholecystectomy
  • Spiral computed tomography