The Cystic Artery in 100 cases of Laparoscopic Cholecystectomy: an Anatomical Variation that is maintained.
Keywords:
cystic artery (CA), cystic duct (CD), gallbladder (VB), laparoscopic cholecystectomy (LC), cystohepatic trigone (CCT), Ecuadorian Institute of Social Security (IESS)Abstract
Laparoscopic cholecystectomy (LC) is the treatment of choice for cholelithiasis; one of its advantages is its low morbidity; However, it is not free of complications that can be diverse. Identification and ligation of the cystic artery (CA) is a mandatory step of a LC; hemorrhage due to inadvertent injury to the cystic artery causes morbidity attributed to the difficulty of identifying it; Recognition and assessment of variations in the AC and bile ducts can minimize eventual complications. The laparoscopic image is different for each person, and can cause some confusion, especially when a surgeon begins his training. At the Teodoro Maldonado Carbo Hospital of the IESS, 100 laparoscopic cholecystectomies were evaluated from January to May 2024 operated on for cholelithiasis, attended by the same surgical team, using a standard of observation and dissection; The history of preoperative pain episodes in HD was considered in the clinical history. In order to establish anatomical guidelines for the location of the cystic artery and its relationship with the cystic duct, the images were examined at 0° and cases with the presence of an accessory cystic artery were discarded. A pattern of behavior of the cystic artery in relation to the cystic duct was established, taking into account the clinical history, especially preoperative pain, to consider it as a predictive factor in order to optimize laparoscopic cholecystectomy in cholelithiasis.
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