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A D V E R T I S E M E N T
A D V E R T I S E M E N T
The cystic artery arises from the right hepatic artery within the hepatocystic triangle, forming the triangle of Calot. The course of the artery is often marked by a sentinel lymph node (Calot's node). The artery gives off a small cystic duct branch and usually divides into two branches near the infundibulum of the gallbladder. The superficial branch is visible on the free surface of the gallbladder when the latter is elevated. The deep branch (viewed here in its normal anatomical position, as if seen through the liver substance) lies between the hepatic surface of the gallbladder and the gallbladder bed.
A D V E R T I S E M E N T
In 25% of individuals, the cystic artery arises outside the hepatocystic triangle, from any of the regional vessels. These variants usually cross anterior to the common duct to reach the gallbladder. In a small percent of cases, the two cystic artery branches arise independently, usually both from the right hepatic, rather than bifurcating from a common trunk.
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A D V E R T I S E M E N T
An example of the cystic artery bifurcation is shown. The cystic duct has been divided and the cystic artery traced to its division near the infundibulum/cystic duct junction. The size of this artery raised concern, and its course needed to be definitively traced to the gallbladder before division. Every structure must be clearly identified during laparoscopic cholecystectomy, but it is particularly critical to identify any structure larger than 3mm in order to avoid injuring a major vessel or duct.
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This page was last modified on 4/9/2002.
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