An Integrated Autopsy based Study on Variations in Origin of Right and Left Hepatic Arteries & Cystic Artery in Light of Hepato-Biliary Surgery
Keywords:laparoscopy,Cholecystectomy, cystic artery, hepatic artery proper, porta hepatis, right hepatic artery, left hepatic artery
Background: Laparoscopic Cholecystectomy is widely accepted as the gold standard in the treatment of
cholelithiasis and this new technique was initially associated with a significant increase in morbidity, and in
particular, in iatrogenic biliary injury and arterial haemorrhage, perhaps due to a lack of knowledge of the
laparoscopic anatomy of the gallbladder pedicle.The arterial system of human body is often subjected to a
good number of variations. Therefore, trying to find out variations in origin of right and left hepatic arteries
and also cystic artery will surely be a useful endeavor for an Anatomist and Autopsy Surgeon, moreover
such an effort will help the surgeons in planning and operating upon the hepatobiliary system. Method:The
present work was carried out in the Department of FMT, NRSMCH, Kolkata in collaboration with the
Department of Anatomy, Medical College, Kolkata over a period of one year to find out variations ion
origin of right and left hepatic arteries and cystic artery. Fifty cadavers of both sexes were subjected to detail
dissection method based on inclusion and exclusion criteria. The study was prospective, cross sectional,
observational, autopsy based study.
Conclusion:In 92% cases total number of branches from the HAP were three, four branches were arising
from it in 6% cases, whereas >four branches from the HAP in remaining 2% cases.The branching pattern of
the HAP at the porta hepatis showed bifurcation in 96 % cases, whereas HAP showed trifurcation pattern at
porta hepatis in 4% cases.Any source of origin of the RHA and LHA other than the HAP was recorded as
0%. The percentage of occurrence of accessory or replaced RHA was 0%.This was also the case with LHA.
The present study revealed the RHA (92%) being the commonest source of origin of cystic artery. In 8%
cases cystic artery represented variant origin. Variant origins of CA were represented by the HAP (6%) and
GDA (2%).In 96% of cases, the cystic artery was single. Remaining 4% of cadavers showed presence of
more than one cystic artery, the number being two.Most significant finding in this present study according
to the researcher is the presence of double cystic arteries.
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