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The unwanted third wheel in the Calot's triangle: Incidence and surgical significance of caterpillar hump of right hepatic artery with a systematic review of the literature

BACKGROUND: Caterpillar hump of the right hepatic artery is a rare variation increasing the risk of vascular and biliary injuries during hepatobiliary surgery. The aim of this study is to record the cases of the right hepatic artery forming caterpillar hump in a cohort of patients underwent laparosc...

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Autores principales: Marano, Luigi, Bartoli, Alberto, Polom, Karol, Bellochi, Raffaele, Spaziani, Alessandro, Castagnoli, Giampaolo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6561071/
https://www.ncbi.nlm.nih.gov/pubmed/29737324
http://dx.doi.org/10.4103/jmas.JMAS_75_18
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author Marano, Luigi
Bartoli, Alberto
Polom, Karol
Bellochi, Raffaele
Spaziani, Alessandro
Castagnoli, Giampaolo
author_facet Marano, Luigi
Bartoli, Alberto
Polom, Karol
Bellochi, Raffaele
Spaziani, Alessandro
Castagnoli, Giampaolo
author_sort Marano, Luigi
collection PubMed
description BACKGROUND: Caterpillar hump of the right hepatic artery is a rare variation increasing the risk of vascular and biliary injuries during hepatobiliary surgery. The aim of this study is to record the cases of the right hepatic artery forming caterpillar hump in a cohort of patients underwent laparoscopic cholecystectomy and to report a review of the literature systematically conducted. METHODS: We reviewed clinical and surgical video data of 230 patients with symptomatic cholelithiasis treated with laparoscopic cholecystectomy between January 2016 and August 2017. A systematic literature search in PubMed, Medline, Cochrane and Ovid databases until 30(th) June 2017 was also performed in accordance with the PRISMA statement. RESULTS: Our institutional data indicated that 1.3% of 230 patients presented caterpillar hump right hepatic artery. The systematic review included 16 studies reporting data from a total of 498 human cadavers and 579 patients submitted to cholecystectomy. The overall proportion of surgical patients with the caterpillar hump right hepatic artery was 6.9%. CONCLUSIONS: Variations of the cystic artery are not just an anatomical dissertation, assuming a very crucial role in surgical strategies to avoid uncontrolled vascular lesions. A meticulous knowledge of the hepatobiliary triangle in association with all elements of ‘Culture of Safety in Cholecystectomy’ is mandatory for surgeons facing more than two structures within Calot's triangle.
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spelling pubmed-65610712019-07-01 The unwanted third wheel in the Calot's triangle: Incidence and surgical significance of caterpillar hump of right hepatic artery with a systematic review of the literature Marano, Luigi Bartoli, Alberto Polom, Karol Bellochi, Raffaele Spaziani, Alessandro Castagnoli, Giampaolo J Minim Access Surg Systematic Review BACKGROUND: Caterpillar hump of the right hepatic artery is a rare variation increasing the risk of vascular and biliary injuries during hepatobiliary surgery. The aim of this study is to record the cases of the right hepatic artery forming caterpillar hump in a cohort of patients underwent laparoscopic cholecystectomy and to report a review of the literature systematically conducted. METHODS: We reviewed clinical and surgical video data of 230 patients with symptomatic cholelithiasis treated with laparoscopic cholecystectomy between January 2016 and August 2017. A systematic literature search in PubMed, Medline, Cochrane and Ovid databases until 30(th) June 2017 was also performed in accordance with the PRISMA statement. RESULTS: Our institutional data indicated that 1.3% of 230 patients presented caterpillar hump right hepatic artery. The systematic review included 16 studies reporting data from a total of 498 human cadavers and 579 patients submitted to cholecystectomy. The overall proportion of surgical patients with the caterpillar hump right hepatic artery was 6.9%. CONCLUSIONS: Variations of the cystic artery are not just an anatomical dissertation, assuming a very crucial role in surgical strategies to avoid uncontrolled vascular lesions. A meticulous knowledge of the hepatobiliary triangle in association with all elements of ‘Culture of Safety in Cholecystectomy’ is mandatory for surgeons facing more than two structures within Calot's triangle. Wolters Kluwer - Medknow 2019 /pmc/articles/PMC6561071/ /pubmed/29737324 http://dx.doi.org/10.4103/jmas.JMAS_75_18 Text en Copyright: © 2018 Journal of Minimal Access Surgery http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Systematic Review
Marano, Luigi
Bartoli, Alberto
Polom, Karol
Bellochi, Raffaele
Spaziani, Alessandro
Castagnoli, Giampaolo
The unwanted third wheel in the Calot's triangle: Incidence and surgical significance of caterpillar hump of right hepatic artery with a systematic review of the literature
title The unwanted third wheel in the Calot's triangle: Incidence and surgical significance of caterpillar hump of right hepatic artery with a systematic review of the literature
title_full The unwanted third wheel in the Calot's triangle: Incidence and surgical significance of caterpillar hump of right hepatic artery with a systematic review of the literature
title_fullStr The unwanted third wheel in the Calot's triangle: Incidence and surgical significance of caterpillar hump of right hepatic artery with a systematic review of the literature
title_full_unstemmed The unwanted third wheel in the Calot's triangle: Incidence and surgical significance of caterpillar hump of right hepatic artery with a systematic review of the literature
title_short The unwanted third wheel in the Calot's triangle: Incidence and surgical significance of caterpillar hump of right hepatic artery with a systematic review of the literature
title_sort unwanted third wheel in the calot's triangle: incidence and surgical significance of caterpillar hump of right hepatic artery with a systematic review of the literature
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6561071/
https://www.ncbi.nlm.nih.gov/pubmed/29737324
http://dx.doi.org/10.4103/jmas.JMAS_75_18
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