Prospective observational study to assess the prevalence of double cystic artery
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 10, Pages 4039-4045
AbstractAim: The aim of this study was to find out the prevalence of double cystic arteries.
Material and methods: The study was a prospective observational study conducted in the Department of General Surgery, Vardhman Mahavir Medical College and safdarjung Hospital, New Delhi, India for 12 months. Total 450 patients with symptomatic gallstones with benign gallbladder diseases, gallbladder polyps, previously known gallbladder inflammation, patients without bleeding clotting disorder, being over the age of 18, and patients who can be given general anesthesia induction and underwent laparoscopic cholecystectomy operation were include in this study. The characteristics and complications of the patients with double cystic artery were recorded and examined.
Results: Among 450, 110 male and 340 female and the double cystic arteries were detected in the operation of 4 males (0.88%) and 12 female patients (2.67%). The average age of these patients was 52.4±12.85. It was discovered from ultrasound reports that the indication for operation in 3 of the 13 patients with double cystic arteries was gall bladder polyp while it was multiple stones in the gallbladder for the rest of the patients. The oral anti-diabetic-regulated diabetes mellitus was detected in 3 female patients, and hypertension was detected in 2 male patients. An epigastric hernia was detected in 3 patients other than gallstones and an epigastric hernia correction was performed simultaneously laparoscopically. 4 of the 16 patients (25%) with double cystic arteries were switched from laparoscopic to conventional cholecystectomy due to bleeding during surgery. Bile duct injury was detected postoperatively in 3 male patients with a double cystic artery. Upon the detection of 300 ml bile fistula from the postoperative drain of the patient, the injury was detected with the help of MR- cholangiography, and a stent was placed in the common bile duct with the help of endoscopic retrograde cholangiopancreatography (ERCP).The average duration of hospital stay of patients with a double cystic artery is 5.7 (4-13)days, and (3.1 days) for patients without a double cystic artery. The incidence of a double cystic artery was found to be 3.55 on average.
Conclusion: Cystic artery variations and other variations can coexist. Awareness of cystic artery variations can reduce the possibility of uncontrolled intraoperative bleeding, extra hepatic biliary injury, and switching to conventional cholecystectomy.
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