Vascular and Gallbladder Variations in Laparoscopic Cholecystectomy

Ubaid Hamza, Mohammed; Abood Jaffar, Akram; Ahmed Hassan, Hassan

	Vascular and Gallbladder Variations in Laparoscopic Cholecystectomy
Medical Journal of Babylon
Article 1, Volume 5, Issue 1, 2008, Pages 119-134
Authors
Mohammed Ubaid Hamza; Akram Abood Jaffar; Hassan Ahmed Hassan
Abstract
Most laparoscopic cholecystectomies are performed after ultrasound examination in combination with clinical and biochemical parameters. The most reliable method to assess anatomy in living people is during the surgery, so a clean dissection, accurate visual identification, and a profound knowledge of expected variations are essential. In order to alert the surgeon and to reduce the incidence of complications, we describe the clinical anatomy of vascular and gallbladder variations faced during fifty laparoscopic cholecystectomies. Vascular anomalies were present in 18% of the patients; they include: caterpillar hump of the right hepatic artery, early division of cystic artery, low-inserted cystic artery, cystic artery originating from proper hepatic artery, and a rare anatomical variation whereby the right hepatic artery was found in the gallbladder bed. Gallbladder anomalies were present in 14% of the patients; they include: intrahepatic gallbladder, “Phrygian cap” gallbladder, and a case of situs inversus. The incidence, surgical anatomy, and operative maneuvers of the anomalous cases were discussed.

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