Study On Anatomic Variation Of Cystic Artery In Laparoscopic Cholecystectomy

Objective: Through the characteristics of direct observation of laparoscopy,the anatomic variation of cystic artery in healthy and pathological conditions is studies in surgery about laparoscopic cholecystectomy.And the classification so as to reduce the variance,laparoscopic cholecystectomy for gallbladder artery injury caused by bleeding and variation are summarized.Methods : The patients with gallbladder diseases were treated by laparoscopic cholecystectomy to observe the anatomical structure of gallbladder artery and adjacent Calot within the triangle area.According to the analysis of the hospital image acquisition,which provides anatomical image,the laparoscopic gallbladder artery anatomy and variation is further explored.Results:1.A total of four types of cystic artery branches are summarized in this study.They are listed as follow: single type was 154 cases(63%),double branch type was 56 cases(23%),and branch type was 29 cases(12%)and the cystic artery absent or small was 6 cases(2%).2.Cystic artery discharge: 181 cases(74%)from the right hepatic artery;40 cases(16%)from the liver proper artery;12 cases(5%)from the left hepatic artery;12 cases(5%)from the gastroduodenal artery.There were 186 cases(76%)of the cystic artery starting from the Calot triangle.There were 59 cases(24%)from the cystic artery outside the Calot triangle.There were 40 cases(25.98%)in the anterior hepatic duct and the common bile duct in 154 cases of the single cystic artery.There were 23 cases(15%)who traveled through the common hepatic duct or the common bile duct.85 cases of double and multiple types of cystic artery branch,go for liver and bile duct in front of 28 cases(33%),branch go in hepatic duct or common bile duct behind 18 cases(21%),39 cases were in left hepatic duct or common bile duct of front and rear(46%).3.The single cystic cystic artery runs through the Calot triangle in 127 cases(82.53%).The cystic artery does not pass through the Calot triangle,and there are 27 cases(17.47%).There were 15 cases of double support cystic artery in the gallbladder triangle(26.31%).There was 40 cases(70.78%)only one branch in the gallbladder triangle.There were no gallbladder triangle in 1 cases(2.91%).4.There are 126 cases(81.93%)single type of gallbladder artery from the cystic duct to medial and 12 cases(7.63%)since the rear walking into the gallbladder cystic duct.At same time,there are go 11 cases of gallbladder(7.34%)from the front tube and reach the gallbladder and 5 cases of gallbladder(2.90%)walk to reach the gallbladder from outside the tube.5.Laparoscopic lymph node found around gallbladder artery and branches in 196 cases(79.98%).The number of lymph node not found around the gallbladder artery and branches in 9 cases(3.81%),at the time of surgery not see lymph nodes in 39 cases(16.21%).6.The distribution of gallbladder artery through the cystic wall of the normal point of arrival is discribed as Following: near the ampulla of the gallbladder wall with cystic artery into the point with a total of 243,accounting for 66.7%;close to the body within the gallbladder artery at 115,accounting for 32.1%;to reach the gallbladder wall of gallbladder duct gallbladder vein with 7 points accounted for 1.9%.Conclusion:Through the study of the cystic artery branches,origin,walking and variation,it provide guidance for laparoscopic cholecystectomy clinical research.In order to avoid the area of cystic artery,it provide anatomic data for damaged parts caused by adjacent tissue surgery and conducive to the processing and application during operation.