Anatomical Study of Variations of Cystic Artery and Contents of Calot???s Triangle in South Kerala - A Cross Sectional Study

Author(s): Leena Ammini Bhaskaran1, Romi Sadanandan2, Lathikumari Kalyanikutty3

Cystic artery originates from right hepatic artery which is a branch of hepatic artery
proper of coeliac trunk from abdominal aorta. Variations in the origin and course
of cystic artery were observed in this study. Contents of Calot’s triangle were also
studied. Knowledge of normal anatomy, variations of the biliary apparatus and the
arterial supply to the gallbladder is important for surgeon.
Descriptive cross-sectional study was done from April 2008 to January 2010 in 180
adult specimens and 50 foetal specimens in the Departments of Anatomy, Forensic
Medicine and Pathology in Government Medical College, Thiruvananthapuram. The
abdominal wall was incised and hepatobiliary region was identified and dissected.
The gallbladder and coeliac trunk were identified. Cystic artery and Calot’s triangle
were studied.
More than 90 percent of the cystic artery originates from the right hepatic artery
in both sexes. Cystic artery originated from left hepatic artery in 4 cases, common
hepatic artery in 5 cases and from middle hepatic artery in 1 case. The cystic artery
within Calot’s triangle was observed in 41 %. Right hepatic artery was content in
29.9 %. Both the arteries were content in 19 %. Cystic artery and accessory
hepatic duct were content of Calot’s triangle in 2.2 %. Double cystic artery was
content of the triangle in 1 cadaver. Artery or duct was seen outside the Calot’s
triangle in 16 cadavers.
It is important for surgeons to know the variations of cystic artery and Calot’s
triangle during surgical interventions of the hepato biliary region. “Cystic artery
syndrome” is a condition where cystic artery is seen winding around cystic duct
although it originates from right hepatic artery. Knowledge of these variations is
important for surgeons and helps in better surgical outcome.