胆囊动脉的解剖及分型的临床意义

doi:10.13418/j.issn.1001-165x.2014.01.005

Abstract

Abstract:

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.

Key words: Cystic artery, Extrahepatic bile duct, Extrahepatic vessels, Variation, Classification

CLC Number:

R323.3

HU Meng-Feng, LIN Chi, MO Ting-Ting, DENG Mo-Li, SUN Shan-Quan. The anatomy of cystic artery and its clinical classification[J]. Chinese Journal of Clinical Anatomy, 2014, 32(1): 16-21.

References

[1] 周生辉, 叶明. 腹腔镜胆囊切除术胆囊动脉出血的预防和处理
[J]. 现代中西医结合杂志, 2007,16(26):3849-3850.

[2] 张健康. 腹腔镜胆囊切除术出血的原因及对策
[J]. 临床和实验医学杂志, 2011,10(18):1463-1463，1465.

[3] 李卓. 腹腔镜胆囊切除术胆囊动脉出血的预防及处理
[J]. Analysis of treatment and prevention of cystic artery bleeding in the laparoscopic cholecystectomy,2012,39(17):4602-4603.

[4] Flint ER. Abnormalities of the right hepatic, cystic, and gastroduodenal arteries, and of the bile-ducts
[J]. British Journal of Surgery,1923,10(40):509-519.

[5] Michels NA. The hepatic, cystic and retroduodenal arteries and their relations to the biliary ducts with samples of the entire celiacal blood supply
[J]. Ann Surg,1951,133(4):503-524.

[6] 李松林, 任作航. 胆囊动脉变异与腹腔镜胆囊切除术
[J]. 腹腔镜外科杂志, 2002,7(1):12-14.

[7] Abdalla S, Pierre S, Ellis H. Calot's triangle
[J]. Clin Anat,2013,26(4):493-501.

[8] 张年甲. 胆囊动脉的变异(国人腹部血管调查研究之一)
[J]. 解剖学报,1958, 3(2):123-134+153.

[9] 郁秉辉. 50例童尸胆囊动脉的观察
[J]. 解剖学报,1964, 7(3):357-366.

[10]白希文. 胆囊动脉与胆囊管异常及其临床意义
[J]. 实用外科杂志,1982, 2(1):9-10.

[11]Ata AH. Cystic artery identification during laparoscopic cholecystec tomy
[J]. J Laparoendosc Surg,1991,1(6):313-318.

[12]Scott-Conner CE, Hall TJ. Variant arterial anatomy in laparoscopic cholecystectomy
[J]. Am J Surg,1992,163(6):590-592.

[13]Duric B, Ignjatovic D, Zivanovic V. New aspects in laparoscopic cystic artery anatomy
[J]. Acta Chir Iugosl,2000,47(3):105-107.

[14]程田志, 刘荣志. 国人胆囊动脉解剖综述及其临床意义
[J]. 解剖与临床,2006, 11(2):139-141.

[15]Ding YM, Wang B, Wang WX, et al. New classification of the anatomic variations of cystic artery during laparoscopic cholecystectomy
[J]. World J Gastroenterol,2007,13(42):5629-5634.

[16]Chen TH, Shyu JF, Chen CH, et al. Variations of the cystic artery in Chinese adults
[J]. Surg Laparosc Endosc Percutan Tech,2000,10(3):154-157.

[17]孟镔, 朱传军, 杨志欣, 等. 胆囊动脉起自胃左动脉及其分支变异1例
[J]. 中国临床解剖学杂志,2007,25(5):1.

[18]吴爱群, 邹玉明. 胆囊动脉来源于胰-空肠动脉一例
[J]. 解剖学杂志,2011,34(2):11.

[19]Suzuki M, Akaishi S, Rikiyama T, et al. Laparoscopic cholecystect omy, Calot's triangle, and variations in cystic arterial supply
[J]. Surg Endosc,2000,14(2):141-144.

[20]冯明, 孙善全. 与lc术有关的胆囊动脉解剖
[J]. 中国临床解剖学杂志, 1999, 17(1):45-47.

[21]Balija M, Huis M, Stulhofer M, et al.
[Contribution to the nomenclature of variations of the cystic artery]
[J]. Chirurg,2001,72(2):154-158.

[22]Sanjay P, Kulli C, Polignano FM, et al. Optimal surgical technique, use of intra-operative cholangiography (IOC), and management of acute gallbladder disease: the results of a nation-wide survey in the UK and Ireland
[J]. Ann R Coll Surg Engl,2010,92(4):302-306.

The anatomy of cystic artery and its clinical classification

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Metrics

Comments

Recommended 0

[1]	Jiang Jianhong, Duan Renpeng, Li Xiaofeng. Application of three-dimensional visualization technology in the anatomical variations of hilar bile ducts in Chinese population [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 1-4.
[2]	Cidanwangjiu, Luosangduoji, Lazi, Labadunzhu, Nima . Multi-slice CT observation of renal artery variability in Tibetan adults [J]. Chinese Journal of Clinical Anatomy, 2023, 41(6): 680-683.
[3]	Lian Peirong, Chen Hu, Yi Honglei, Feng Zhibin, Tu Qing, Xia Hong. Review of classification of the course variation of the suboccipital vertebral artery and its clinical application [J]. Chinese Journal of Clinical Anatomy, 2023, 41(6): 746-750.
[4]	Xu Daqiang, Sun Peidong, Zhao Jiali, Yang Huilin, Ouyang Jun. Comparison of compressive ability and compression-induced damage to the pilot hole between the two-segmental lag screw and AO lag screw [J]. Chinese Journal of Clinical Anatomy, 2022, 40(6): 710-713.
[5]	Zhang Peng, Chen Xin, Zhang Lan, Lin Yao, Lv Jianbo, Zeng Xinyu, Wang Zheng, Li Xin, Jin Yao, Tao Kaixiong. Anatomy of the inferior mesenteric artery evaluated by three-dimensional CT angiography before radical resection of rectal cancer [J]. Chinese Journal of Clinical Anatomy, 2022, 40(5): 530-535.
[6]	Hu Dingxiang, Li Changhui, Chen Liang, Ma Chenxi, Huang He, Zheng Ruiqing. Morphological classification and clinical significance of glenoid based on CT three-dimensional reconstruction [J]. Chinese Journal of Clinical Anatomy, 2022, 40(2): 150-153.
[7]	Xu Fusheng, Zhang Wei, Niu Fei, Cheng Anyuan, Xia Ping. Fracture classification for distal pole of patella fractures based on CT [J]. Chinese Journal of Clinical Anatomy, 2021, 39(6): 646-648.
[8]	Huang Fuming, Fan Shicai, Huang Haizhou, Zhou Jihui, Lin Shibang. Selection of surgical approach based on three-column classification for acetabular fractures [J]. Chinese Journal of Clinical Anatomy, 2021, 39(6): 750-754.
[9]	Shen Jiayi, Lv Lingchun, ChenJun, Zhao Yanan, Lu Chenying, Wei Tiemin. Imaging anatomic characteristics of renal artery in middle-old aged people from southwest Zhejiang province [J]. Chinese Journal of Clinical Anatomy, 2021, 39(5): 546-551.
[10]	Zhou Yunfeng, Xu Dazheng, Chen Zhong, Yao Huosheng, Zhang Congda, Li Weiping, Shen Huiyong, Song Bin. Morphological classification of the lateral ankle ligaments and clinical significance [J]. Chinese Journal of Clinical Anatomy, 2021, 39(2): 121-125.
[11]	HUANG Hui-yong, LI Huan, YANG Xiu, WU Zhen . The anatomical variation of superior petrosal vein and superior petrosal sinus and its management and lesson during the surgery for petroclival meningioma [J]. Chinese Journal of Clinical Anatomy, 2020, 38(5): 528-535.
[12]	CHEN Chun-ling, ZHUANG Yong-qing, ZHANG Xuan, LIU Zhao-kang . A new clinical classification and therapy analysis of the central slip injury in extensor tendon [J]. Chinese Journal of Clinical Anatomy, 2020, 38(3): 335-338.
[13]	HOU Yan-hong, CUI Ai-ling, LIU Xue-min, LI Jian-bin, LI Ming, CAO Jing. The anatomic features of variant hepatic artery and its possible clinical significance [J]. Chinese Journal of Clinical Anatomy, 2019, 37(4): 366-370.
[14]	ZHANG Wen-yi，GAO Feng, YI Zhi-qiang, LIU Ai-xian. Clinical application of triangular anatomy and area of cavernous sinus [J]. Chinese Journal Of Clinical Anatomy, 2019, 37(1): 1-4.
[15]	. Digital study and code analysis of the left branch of hepatic portal vein [J]. Chinese Journal Of Clinical Anatomy, 2019, 37(1): 25-29.