胆囊动脉的解剖及分型的临床意义
The anatomy of cystic artery and its clinical classification
目的 为腹腔镜胆囊切除术（LC）及其他肝外胆道手术提供胆囊动脉（CA）的形态学基础。 方法 经福尔马林固定的尸体45具，充分解剖暴露腹腔动脉、肠系膜上动脉(SMA)及其分支，仔细记录CA的起源、数量和行径，并作统计学分析。 结果 根据CA与Calot’s三角的关系， CA可分为4型： I型：CA走行在Calot’s三角内，占77.8%（35例），其中单CA占68.9%（31例），双CAs占8.9%（4例）；II型：CA走行于Calot’s三角之外，占15.6%（7例）；III型 ：混合型，即存在多条CAs，分别位于Calot’s三角内和外，占4.4%（2例）；Ⅳ型：非典型Calot’s三角型，即CA走行在非典型Calot’s三角内，占2.2%（1例）。 结论 根据CA与Calot’s三角的关系，CA可分为4型，其变异复杂，且具不可预测性，在相关手术时应提高警惕，以避免LC术中或术后出血等并发症的发生。
Objective To investigate the anatomic variations of cystic artery（CA）, so as to provide morphological basis for laparoscopic cholecystectomy（LC）. Methods A total of 45 cadavers were randomly collected. Arteries including abdominal aorta, celiac artery， superior mesenteric artery and their branches were dissected. The origin, course and the relations of CA to the surrounding structures were observed and statistically analyzed. Results According to the relations of CA to the Calot’s triangle, the CAs in this study could be divided into 4 types: Type I CA within Calot’s triangle (n=35,77.8%),including one CA(n=31,68.9%) and double CAs(n=4,8.9%); Type II CA outside Calot’s triangle（n=2, 15.6%）; Type III compound type, with at least one CA within Calot’s triangle and others beyond it（n=2,4.4 %）; Type Ⅳ CA within atypical Calot’s triangle(n=1, 2.2% ). Conclusion Based on the relations of CA to the Calot’s triangle, CA can be divided into four types, implying the origin and the course of CA are so complicated and unexpected in some degree that surgeons should pay close attention to these unpredictable variations to avoid occurrence of complications during or after LC.
Cystic artery / Extrahepatic bile duct / Extrahepatic vessels / Variation / Classification
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