Origin of cystic artery from hepatic artery proper and its surgical implications

Sachin Patil, Kumkum Rana, Smita Kakar, Anilkumar Mittal


Cystic artery is usually a branch of right hepatic artery given in the Calot’s triangle. Variations in the origin of cystic artery have been reported but there is paucity of literature regarding these in Indian subjects. The present case describes the origin of cystic artery from the hepatic artery proper, with an unusual course, which was detected during routine cadaveric dissection. The development of biliary vasculature is quite complex and it accounts for many variations. Knowledge of cystic artery variability facilitates intraoperative identification of vessels in both classical and laparoscopic surgery of the bile ducts. This emphasises the importance of a thorough knowledge of the cystic arterial variations that often occur and may be encountered during both laparoscopic and open cholecystectomy. Uncontrolled bleeding from the cystic artery and its branches is a serious problem that may increase the risk of intraoperative lesions to vital vascular and biliary structures during hepatobiliary surgery.


Cystic artery, Hepatic artery proper, Calot’s triangle, Anatomical variation

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Bakheit MA. Prevalence of variations of the cystic artery in the Sudanese. East Mediterr Health J 2009;15:1308-12.

Torres K, Chroscicki A, Golonka A, Torres A, Staskiewicz G Palczak R, et al. The course of the cystic artery during laparoscopic cholecystectomy. Folia Morphol (Warsz) 2009;68:140-3.

Chen TH, Shyu JF, Chen CH, Ma KH, Wu CW, Lui WY, Liu JC. Variations of the cystic artery in Chinese adults. Surg Laparosc Endosc Percutan Tech 2000;10:154-7.

Hlaing KP, Thwin SS, Shwe N. Unique origin of the cystic artery. Singapore Med J 2011;52:e262-4.

Sarkar AK, Roy TS. Anatomy of the cystic artery arising from the gastroduodenal artery and its choledochal branch-a case report. J Anat 2000;197:503-6.

Ding YM, Wang B, Wang WX, Wang P, Yan JS. New classification of the anatomic variations of cystic artery during laparoscopic cholecystectomy. World J Gastroenterol 2007;13:5629-34.

Pushpalatha K, Shamsundar NM. Variation in the origin of the cystic artery. J Anat Soc India 2010;59:35-7.

Loukas M, Fergurson A, Louis RG Jr, Colborn GL. Multiple variations of the hepatobiliary vasculature including double cystic arteries, accessory left hepatic artery and hepatosplenic trunk: a case report. Surg Radiol Anat 2006;28:525-8.

Saidi H, Karanja TM, Ogengo JA. Variant anatomy of the cystic artery in adult Kenyans. Clin Anat 2007;20:943-5.

Vishnumaya G, Potu BK, Gorantla VR, Thejodhar P. Anomalous Origin of Cystic Artery from Gastroduodenal artery- A Case Report. Int J Morphol 2008;26:75-6.