Assessment and classification of cystic arteries with 64-detector row computed tomography before laparoscopic cholecystectomy.
OBJECTIVE
Major complications of laparoscopic cholecystectomy are bleeding and bile duct injury, and it is necessary to clearly identify structures endoscopically to keep bleeding and injury from occurring. The aim of this study was to depict the anatomical variation between cystic arteries among patients using 64-detector row spiral computed tomography (CT) prior to laparoscopic cholecystectomy.


METHODS
A total of 78 patients (31 men, 47 women) who underwent cholecystectomy were examined preoperatively using 64-detector row spiral CT between April 2012 and June 2013. The origin and number of cystic arteries and their relationship with the Calot triangle was evaluated by two independent observers. CT images were compared with laparoscopic cholecystectomy results.


RESULTS
The cystic arteries were delineated by CT in 73 of the 78 patients. The relationship between the cystic arteries and the Calot triangle was identified in 71 of the 78 patients. One cystic artery was found in 53 (73%) of the 73 patients, while two cystic arteries were found in 20 (27%) of the patients. A total of 55 (60%) of the 91 cystic arteries passed through the Calot triangle. The remaining 36 cystic arteries (40%) passed anterior, posterior, or inferior to the cystic duct. The relationship between the cystic arteries and the Calot triangle detected by CT was in agreement with the surgical records for all patients.


CONCLUSIONS
The configuration of the cystic arteries and their relationship with the Calot triangle can be identified using 64-detector row CT before laparoscopic cholecystectomy.
Department of Radiology, Shanghai Songjiang Central Hospital, Shanghai, 201699, People's Republic of China. xiajd_21@163.com.
Jindong
J
Xia
Department of Radiology, School of Medicine, Shanghai First People's Hospital, Shanghai Jiaotong University, Shanghai, 200080, People's Republic of China. befate@126.com.
Zaixian
Z
Zhang
Department of Radiology, Shanghai Songjiang Central Hospital, Shanghai, 201699, People's Republic of China. huryoung@163.com.
Yao
Y
He
Department of Radiology, Shanghai Songjiang Central Hospital, Shanghai, 201699, People's Republic of China. qujiao2000@163.com.
Jiao
J
Qu
Department of Radiology, School of Medicine, Shanghai First People's Hospital, Shanghai Jiaotong University, Shanghai, 200080, People's Republic of China. jiayoung@foxmail.com.
Jia
J
Yang
D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic; D002765:Cholecystography; D005260:Female; D005704:Gallbladder / Q000098:blood supply* / Q000601:surgery; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D014057:Tomography, X-Ray Computed
Calot triangle; Cystic artery; Laparoscopic cholecystectomy; Spiral computed tomography