Hugh T B, Kelly M D, Li B
Department of General Surgery, St. Vincent's Hospital, Sydney, New South Wales, Australia.
Am J Surg. 1992 Jun;163(6):593-5. doi: 10.1016/0002-9610(92)90564-8.
Uncontrolled arterial bleeding during laparoscopic cholecystectomy is a serious problem and may increase the risk of bile duct damage. Therefore, accurate identification of the anatomy of the cystic artery is important. We reviewed the anatomy of the cystic artery and its variations as seen through the video laparoscope. A "normal" cystic artery was found in only 72% of patients. The most important laparoscopically noted variations were doubling of the cystic artery (22%) and an artery that ran inferior to the cystic duct (6%). Small branches of the cystic artery, which we suggest be named Calot's arteries, supply the cystic duct and may cause troublesome bleeding during laparoscopic dissection in the hepatobiliary triangle. A scissor dissection technique was found most useful for identifying the arterial anatomy. Careful identification of arterial anomalies should help to reduce the incidence of bile duct injuries during laparoscopic cholecystectomy.
腹腔镜胆囊切除术中动脉出血失控是一个严重问题，可能会增加胆管损伤的风险。因此，准确识别胆囊动脉的解剖结构很重要。我们回顾了通过视频腹腔镜观察到的胆囊动脉的解剖结构及其变异情况。仅72%的患者发现有“正常”的胆囊动脉。腹腔镜下最常见的变异是胆囊动脉双支（22%）和走行于胆囊管下方的动脉（6%）。我们建议将胆囊动脉的小分支命名为Calot动脉，其为胆囊管供血，在腹腔镜下解剖肝门三角时可能导致棘手的出血。发现剪刀解剖技术对识别动脉解剖结构最有用。仔细识别动脉异常有助于降低腹腔镜胆囊切除术中胆管损伤的发生率。
