Angiotomography of the Anatomical Variants of the Cystic Artery. Pre-operative Study of Cholelithiasis

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Rafael Coello Cuntó; Ramón Roberto Gómez Araujo; Rafael Gabriel Coello Salguero & Mariano del Sol


Laparoscopic cholecystectomy is the treatment indicated for cholelithiasis, however the procedure is not free of complications or concomitant morbidity. It is possible that, due to collateral ductal lesions, bleeding occurs with the possibility of surgery conversion and undesirable results. For a correct approach to the region it is essential to identify the cystohepatic trigone (CHT) and its components, as well as the ligation and section of the cystic artery (AC). Knowing the high variability of CA, the aim of this work was to identify the number, origin, path and relationship of CA with the CHT and its variations using angiotomography by means of a 64-slice detector tomograph in the preoperative period of 30 female patients, between 24 and 54 years old, with clinically diagnosed cholelithiasis and by echo sonography. The AC in 76.67 % was unique and was within the CHT, in 16.67 % it was unique and was observed outside the CHT. In 6.67 %, two ACs were observed, one inside and one outside the TCH. In 66.67 % of cases, CA originated normally from the right hepatic artery. The traceability of AC was 53.3 % moderately visible and 46.7 % excellent traceability. In conclusion, the identification of AC and its anatomical variations can be determined in the preoperative period and can be useful to improve the surgical plan in patients with cholelithiasis, providing information on the procedure, optimizing it and reducing the risks of possible bleeding related complications.

KEY WORDS: Laparoscopic cholecystectomy; Cystic artery; Cystohepatic trigone; Computed angiotomography; Right hepatic artery; Laparoscopic anatomy.

How to cite this article

COELLO, C. R .; GÓMEZ, A. R. R .; COELLO, S. R. G. & DEL SOL, M. Angiotomography of the anatomical variants of the cystic artery. Preoperative study of cholelithiasis. Int. J. Morphol., 37 (4):1456-1462, 2019.