Users Online : 864 About us |  Subscribe |  e-Alerts  | Feedback | Login   
Journal of Minimal Access Surgery Current Issue | Archives | Ahead Of Print Journal of Minimal Access Surgery
           Print this page Email this page   Small font sizeDefault font sizeIncrease font size 
 ¤   Next article
 ¤   Previous article
 ¤   Table of Contents

 ¤   Similar in PUBMED
 ¤  Search Pubmed for
 ¤  Search in Google Scholar for
 ¤Related articles
 ¤   Citation Manager
 ¤   Access Statistics
 ¤   Reader Comments
 ¤   Email Alert *
 ¤   Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed2525    
    Printed157    
    Emailed0    
    PDF Downloaded147    
    Comments [Add]    

Recommend this journal

 

 SYSTEMATIC REVIEW
Year : 2019  |  Volume : 15  |  Issue : 3  |  Page : 185-191

The unwanted third wheel in the Calot's triangle: Incidence and surgical significance of caterpillar hump of right hepatic artery with a systematic review of the literature


1 Department of Surgery, ‘San Matteo Degli Infermi Hospital’, Spoleto (PG), Italy
2 Department of Surgical Oncology, Medical University of Gdansk, Gdansk, Poland

Correspondence Address:
Luigi Marano
Department of Surgery, ‘San Matteo Degli Infermi Hospital’ - ASL Umbria 2, Via Loreto 3, 06049, Spoleto (PG)
Italy
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmas.JMAS_75_18

Rights and Permissions

Background: Caterpillar hump of the right hepatic artery is a rare variation increasing the risk of vascular and biliary injuries during hepatobiliary surgery. The aim of this study is to record the cases of the right hepatic artery forming caterpillar hump in a cohort of patients underwent laparoscopic cholecystectomy and to report a review of the literature systematically conducted. Methods: We reviewed clinical and surgical video data of 230 patients with symptomatic cholelithiasis treated with laparoscopic cholecystectomy between January 2016 and August 2017. A systematic literature search in PubMed, Medline, Cochrane and Ovid databases until 30th June 2017 was also performed in accordance with the PRISMA statement. Results: Our institutional data indicated that 1.3% of 230 patients presented caterpillar hump right hepatic artery. The systematic review included 16 studies reporting data from a total of 498 human cadavers and 579 patients submitted to cholecystectomy. The overall proportion of surgical patients with the caterpillar hump right hepatic artery was 6.9%. Conclusions: Variations of the cystic artery are not just an anatomical dissertation, assuming a very crucial role in surgical strategies to avoid uncontrolled vascular lesions. A meticulous knowledge of the hepatobiliary triangle in association with all elements of 'Culture of Safety in Cholecystectomy' is mandatory for surgeons facing more than two structures within Calot's triangle.






[FULL TEXT] [PDF]*


        
Print this article     Email this article

© 2004 Journal of Minimal Access Surgery
Published by Wolters Kluwer - Medknow
Online since 15th August '04