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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
A CT scan reconstruction of the caterpillar hump artery seen in the last image is shown.
A D V E R T I S E M E N T
Another example of a large caterpillar hump shows two separate cystic arteries (one clipped, the other clipped and divided). If a vessel is larger than 3mm, it may be a major hepatic branch and not the cystic artery. Division of such a vessel may cause hepatic necrosis if it is the dominant supply to a liver segment.
References:
Skandalakis JE, Gray SW: Embryology for surgeons, Baltimore, Williams & Wilkins, 2nd ed, 1984, pp 282-333.
Bergman RA, Thompson SA, Afifi AK, Compendium of Human Anatomic Variation, Baltimore, Urban & Schwarzenberg, 1988, pp 77, 78, 167.
Hartfield PM, Wise RE: Anatomic variations in the gallbladder and bile ducts, in Felson B (Ed): Roentgenology of the Gallbladder and Biliary Tract. New York, Grune & Stratton, 1976, pp 15-22.
Hiatt JR et al: Surgical anatomy of the hepatic artery in 1000 cases. Ann Surg 220:50-52, 1994.
Wind GG: Applied Laparoscopic Anatomy: Abdomen and Pelvis, Baltimore, Williams & Wilkins, 1991, pp 455-459.
Suzuki M, et al: Laparoscopic cholecystectomy, Calot's triangle, and variations incystic arterial supply, Surgical Endoscopy, (2000) 14: 141-144.
Markle GB IV: Agenesis of the common bile duct, Arch Surg 116: 350-352, 1981.
Moosman DA: The surgical significance of six anomalies of the biliary duct system, SG&O, 131: 655-660, 1970.
Stokes TL, Old L: Cholecystohepatic duct, Am J Surg 135: 703-705, 1978.
Notes:
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This page was last modified on 11/7/2000.
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