Evaluation of Variation in the Calot’s Triangle at a Tertiary Care Hospital in Northern Uttar Pradesh, India: A Cross-sectional Study
Introduction: Cholelithiasis is the most common disease worldwide, and laparoscopic cholecystectomy is the standard treatment of choice. To perform laparoscopic cholecystectomy, it is essential to understand the critical view of safety, which primarily involves the dissection of Calot's tri...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2024-01-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/18871/67329_CE[Ra1]_F[SK]_QC&Ref(AN_SS)_PF1(AG_OM)_PFA(AG_KM)_PN(KM).pdf |
| Summary: | Introduction: Cholelithiasis is the most common disease
worldwide, and laparoscopic cholecystectomy is the standard
treatment of choice. To perform laparoscopic cholecystectomy,
it is essential to understand the critical view of safety, which
primarily involves the dissection of Calot's triangle. Anatomical
variations in Calot's triangle exist, and understanding them
is crucial to avoid unintended situations during surgery.
Mirizzi syndrome, a rare complication in Calot's triangle, can
significantly increase mortality and morbidity rates.
Aim: To evaluate the anatomical variations in the Calot’s triangle.
Materials and Methods: A cross-sectional study was conducted
at Mayo Institute of Medical Sciences, Department of General
Surgery, from October 2021 to September 2022. The total sample
size included 100 patients with gallstone disease who underwent
surgical intervention. Intraoperative findings, such as variations
in the cystic artery and cystic duct, as well as Mirizzi syndrome
grading, were recorded in an Excel sheet and tabulated. The
results were expressed in terms of frequency and percentage.
Results: The average age of the patients was 39.42±12.11
years, with females outnumbering males. Among them, 28%
had a cystic artery lying outside of Calot's triangle, and 96%
had a cystic artery originating from the right hepatic artery. The
remaining 2% originated from an aberrant right hepatic artery,
1% from the left hepatic artery, and 1% from the gastroduodenal
artery. Cystic duct variations were found in 5% of cases. Of
these, 2% had a short cystic duct (<2 cm), 1% had a long cystic
duct (approximately 5 cm), one patient had an absent cystic
duct, and one had a low insertion into the common hepatic duct.
Mirizzi syndrome Grade-I and Grade-II patients accounted for
4% and 2% respectively, while Grade-III, Grade-IV, and Grade-V
each contributed to 1%.
Conclusion: Knowledge of Calot's triangle variations is
crucial, especially for aspiring surgeons, as it helps them
make decisions promptly when encountering difficulties during
surgery. Understanding the Calot's region ensures the safety
not only of patients but also of surgeons. |
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| ISSN: | 2249-782X 0973-709X |