Video-coelioscopic anatomy of the cystic artery

ABSTRACT

Arterial bleeding is a serious problem in laparoscopic cholecystectomy, therefore careful identification of the cystic artery and its anomalies as seen through the video-laparoscope could be of significant help in avoiding one of the greatest problems of biliary surgery, namely iatrogenic injury of the bile ducts. So, we reviewed the anatomy of the cystic artery during 80 laparoscopic cholecystectomies. A normal cystic artery was found in [76.2%] of patients, doubling of the artery in [17.5%] and an artery inferior to the cystic duct in [6.2%]. Dissection of the porta is avoided until the lateral edge of the cystic duct is identified after that identification of the cystic artery is attempted. Cautery and sharp dissection of the tissues in the portal area should be done cautiously to identify any arterial anomalies