Calot triangle or cystohepatic triangle is a small potential triangular space at the porta hepatis of surgical importance as it is dissected during cholecystectomy. Its contents, the cystic artery and cystic duct must be identified before ligation and division to avoid intraoperative injury. The isosceles triangle is positioned so that the apex points towards the liver with the following boundaries:. Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys.
Updating… Please wait. Unable to process the form. Check for errors and try again. Thank you for updating your details. Log In. E-mail: ti. Received Apr 2; Accepted Apr This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.
This article has been cited by other articles in PMC. Abstract Background: Caterpillar hump of the right hepatic artery is a rare variation increasing the risk of vascular and biliary injuries during hepatobiliary surgery.
Methods: We reviewed clinical and surgical video data of patients with symptomatic cholelithiasis treated with laparoscopic cholecystectomy between January and August Results: Our institutional data indicated that 1.
Conclusions: Variations of the cystic artery are not just an anatomical dissertation, assuming a very crucial role in surgical strategies to avoid uncontrolled vascular lesions. Keywords: Calot's triangle variations, caterpillar hump of right hepatic artery, cystic artery variations, laparoscopic cholecystectomy, Moynihan's hump.
Surgical procedure The patient was positioned in the reverse Trendelenburg left lateral position under general anaesthesia. Open in a separate window. Figure 1. Figure 2. Data retrieval The clinical as well as surgical video data of the eligible patients were retrieved and retrospectively reviewed. Statistical analysis The continuous, normally distributed variables are presented as the median and range whereas categorical variables are presented as the number per cent.
Systematic review results The initial search produced studies. Table 1 Characteristics of included studies. Figure 3.
Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest. El Maksoud W. Variant right hepatic artery forming Moynihan's hump, travelling through the gall bladder bed and enter the liver in unusual anterior location. Pak J Surg. Technical aspects of cholecystectomy. Surg Clin North Am. Identification of gallbladder pedicle anatomy during laparoscopic cholecystectomy.
Chir Ital. Tebala GD. Three-port laparoscopic cholecystectomy by harmonic dissection without cystic duct and artery clipping. Am J Surg. World J Gastroenterol. Laparoscopic cholecystectomy by ultrasonic dissection without cystic duct and artery ligature. Surg Endosc.
Biliary tract injury during cholecystectomy: A retrospective descriptive review of clinical features, treatment and outcome. Ceylon Med J. How, when, and why bile duct injury occurs. A comparison between open and laparoscopic cholecystectomy. The critical view of safety: Why it is not the only method of ductal identification within the standard of care in laparoscopic cholecystectomy. Ann Surg. Surg Laparosc Endosc.
New classification of the anatomic variations of cystic artery during laparoscopic cholecystectomy. Complications of laparoscopic cholecystectomy: A national survey of 4, hospitals and an analysis of 77, cases. Kavitha Kamath B. An anatomical study of Moynihan's hump of right hepatic artery and its surgical importance. Flint ER. Abnormalities of the right hepatic, cystic, and gastroduodenal arteries, and of the bile-ducts.
Caterpillar hump of right hepatic artery: Incidence and surgical significance. Vascular and gallbladder variations in laparoscopic cholecystectomy. Med J Babylon. This Issue. June 26, Mervin J. Author Affiliations Iowa City. Access through your institution.
Add or change institution. Save Preferences. The cystic artery may not be found in the triangle of Calot therefore careful dissection and identification of the structures is needed in every surgery. Image modified from the original Singh and Ohri, The superior and inferior sides, represented by the cystic artery and cystic duct, are equal and a little longer than the part of the hepatic duct, which enters into the formation of the triangle. Abdalla, Clin Anat.
Surg Endosc — 3. Philadelphia, 4. Pastel sketch by Dr.
0コメント