The influence of anatomical variations of the cystic artery inside Calot’s triangle on the surgical procedure in patients with carbon dioxide pneumoperitoneum

Introduction: Laparoscopic cholecystectomy is one of the most frequently performed procedures in surgical wards.Proper anatomical identification of structures within the triangle of Calot is essential for the procedure safety.Aim: To evaluate demographic, clinical and anatomical characteristics of 84 patients who underwent laparoscopiccholecystectomies.Material and methods: Anatomical characteristics of Calot’s triangle were correlated with body mass index, genderand age of patients as well as with time of the surgery, type of vascular ligation, presence of adhesions, postoperativebleeding, bile leakage and use of a harmonic scalpel. Additionally, patients’ demographic data were analysed andcompared with data from other patients from Lublin’s state.Results: Obtained anatomical relations of the cystic artery were classified into 2 groups. Group one had typical positionof the cystic artery within Calot’s triangle. Variants were included in group two. Variants of cystic artery wereobserved more frequently in females.Conclusions: We found that the classification of Skandalakis et al. was very detailed, but too complex to be implementedin everyday practice. Therefore we propose a simplified classification which could be used as a practical toolto determine the type of anatomical variation and preserve the safety of the procedure.