Moreover, within the operative scoring system, significantly higher proportion of patients with adhesion burying the gall bladder, distended gall bladder, unable to grasp, Stone [greater than or equal to]1 cm impacted in Hartman's Pouch, bile or pus outside gall bladder and time to identify cystic artery
and duct > 90 minutes were converted to open.
Bleeding from cystic artery
was seen in 5 cases (10% females), complicating 1.17% of our patients.
In group III 3 patients were converted to four port LC, 1 due to bleeding from the cystic artery
and two due to dense adhesion around cystic pedicle.
The gall bladder bed was thoroughly irrigated and cleaned taking extreme care not to dislodge the clips that were placed on the cystic artery
and cystic duct.
This study is conducted to determine predictors of difficult LC, defined as operative time more than 60 min and/ or cystic artery
injury, in the setting of a single academic teaching hospital and in particular to compare the outcomes of LCs performed by surgical trainees with those performed by trained surgeons.
Third, in order to expose the cystic artery
and abnormal anatomy, we can use the same way to flush and aspirate the tissue in the Calot's triangle and identify all the location of main arteries and bile ducts.
(with 5 congenital variations) 11 1.1
Although cholecystitis is the most common cause of cystic artery
aneurysms (1,2,3,4,5,6,7) a review published in 2007(3) identified only 15 cases with this complication.
published articles which contained recommended methods by which the doctor could, and hopefully would, conclusively identify the vital structures, cystic duct, cystic artery
in this procedure?
Gallbladder gets its blood supply from right hepatic artery through cystic artery
. Cystic artery
is an end artery.
A standard laparoscopic cholecystectomy was started; dissection to identify the cystic artery
and duct, ligation of the artery, and a small incision was made in the cystic duct.
Among these 12 patients, both bile duct branches from the gastroduodenal artery and the proper hepatic artery showed the trunk type in 10 patients (20.41%) [Figure 1]b, which included typical double trunk type (from the gastroduodenal artery and the proper hepatic artery) in 8 patients, the right hepatic artery in 1 patient and cystic artery
in 1 patient.