Calot三角的应用解剖学及变异对腹腔镜胆囊切除术的临床意义

目的探讨Calot三角区胆囊动脉、胆囊管及相关结构的解剖关系和变异，进一步充实临床上Calot三角的应用解剖学数据，为减少LC的并发症提供更多的参考依据。方法解剖48具经福尔马林处理的成年尸体标本的Calot三角区，观察胆道及血管的走行分布及与周围组织的解剖关系，测量相关结构的外径和长度。结果胆囊动脉粗细不一，支数不定，发现单支型和双支型，起源与走行也比较复杂；胆囊管与肝总管汇合的方式比较复杂，变异较多，有平行型、骑乘型、螺旋型、极短或缺如，且外径和长度差异有统计学意义（P〈0．01）。结论胆囊动脉和胆囊管的变异较多，术者要熟悉Calot三角的正常应用解剖和常见的变异情况，并充分认识腹腔镜的局限性，才能减少并发症的产生。

Objective To investigate the anatomical relationship and variation of arteriae cystica, cystic ducts and their relative structures in the Calot＇s triangle sector, and to further supply the applied anatomical statistics in order to provide more reference basis for reducing complications. Methods 48 formalin-fixed adult cadavers were dissected. The distribution of cystic ducts and blood vessels as well as their relationships with their adjacent structures was observed and their diameters and lengths were measured. Results Arteriae cystica had different diameters and branches, including single type and double type, as well as complex origins and distributions the methods of confluence of cystic ducts and hepatic ducts were complex variant, and there were significant differences in their diameters and lengths （ P〈0.01 ） . Conclusion Arteriae cystica and cystic ducts variation is more. Being familiar with normal applied anatomy statistics of the Calot＇s triangle and usual variations and fully understand the limitations of laparoscope may reduce the occurrence of complications.