More than two structures in Calot's triangle. A postmortem study.
BACKGROUND
Large laparoscopic cholecystectomy series often fail to report the rate at which a third structure is encountered in Calot's triangle.


METHODS
During a 6-month period, the liver and hepatoduodenal ligament of 90 consecutive human cadavers underwent corrosion casting (n = 50), postmortem arteriography (n = 20), and postmortem cholangiography (n = 20).


RESULTS
Third structures within Calot's triangle were arteries (0.6-5.7 mm diameter) in 36.2% (early division of the right hepatic artery, 8.6%; caterpillar hump right hepatic artery, 12.9%; liver branch of the cystic artery, 10%; double cystic arteries, 5.7%), bile ducts (0.3-1.6 mm diameter) in 5. 7% (small-caliber sectoral ducts, 1.4%; right posterior hepatic ducts, 4.3%), and veins (0.9-1.6 mm diameter) merging with the portal vein in 4% of the specimens.


CONCLUSIONS
Knowledge of the aforementioned anatomy is critical to surgeons facing more than two structures within Calot's triangle during laparoscopic cholecystectomy.
Bergamaschi
R
R
Department of Surgery, University of Bergen, SSSF Hospital, Forde, Norway.
Ignjatovic
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001652:Bile Ducts / Q000033:anatomy & histology*; D002102:Cadaver; D002758:Cholangiography; D017081:Cholecystectomy, Laparoscopic; D016319:Corrosion Casting; D004386:Duodenum / Q000033:anatomy & histology; D005260:Female; D005704:Gallbladder / Q000098:blood supply* / Q000601:surgery; D006499:Hepatic Artery / Q000033:anatomy & histology*; D006503:Hepatic Veins / Q000033:anatomy & histology*; D006801:Humans; D008022:Ligaments / Q000033:anatomy & histology; D008099:Liver / Q000033:anatomy & histology; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000033:anatomy & histology; D012189:Retrospective Studies