加勒比海居民胆囊切除术中胆囊动脉的解剖变异及临床意义

Anatomic variation of cystic artery in cholecystectomy for residents in Caribbean Region and its clinical significance

目的探讨加勒比海居民胆囊切除术中胆囊动脉的解剖变异及临床意义。方法分析"和谐使命-2011"任务期间开展的11例胆囊切除术,开腹2例,腹腔镜9例,总结胆囊动脉各型特点、走行及其进入胆囊的部位。结果主干单支型2例(18.2%),分支型9例(71.2%);2例主干单支型均走行于胆囊三角内,分支型中仅2例各有1分支走行胆囊管后外侧;胆囊动脉进入胆囊的部位以胆囊颈左侧居多(37.5%),Hartmann氏囊、胆囊颈右侧和颈体交界处其次,各占12.5%。结论充分认识当地人群胆囊动脉分型、走行及进入胆囊的常见部位,合理处理Calot三角内解剖结构,可减少术中术后出血,降低肝动脉及胆管损伤的发生率,提高手术成功率。

Objective To study the anatomic variation of cystic artery in cholecystectomy for residents in Caribbean Region and its clinical significance.Methods Of the 11 patients who underwent cholecystectomy during ＂Mission Hormonal 2011＂,9 underwent laparotomy and 2 underwent laparoscopic cholecystectomy.The characteristics,distribution and location of cystic artery were analyzed.Results The main-trunk cystic artery lesion was found in 2 patients（18.2%） and the multiple cystic artery branch lesion was observed in 9 patients（71.2%）.The two main-trunk cystic artery branches were located in the cystic triangle.Of the multiple cystic artery branches,2 were located in the posterolateral cystic duct.The cystic artery was mainly located in the left neck of gallbladder（37.5%） followed by in Hartmann pouch（12.5%）,in right neck of gallbladder（12.5%）,in neck and body juncture（12.5%）.Conclusion Full understanding of the types,distribution and common locations of cystic artery and precise dissection of Calot＇s triangle can reduce intra-operative bleeding,hepatic artery and bile duct injury,thus increasing the success rate of cholecystectomy.