Calot üçgeni sürprizi: Sağ hepatik arterin tırtıl hörgücü varyasyon olguları

Year 2023, Volume: 1 Issue: 1, 18 - 21, 28.02.2023

Ufuk Memiş

Abstract

Kolesistektomi, laparoskopinin yaygınlaşması ile birlikte genel cerrahi kliniklerinin en sık yapılan cerrahi işlemlerinden biri haline gelmiştir. Laparaskopik kolesistektomi akut ve elektif vakalarda standart yaklaşım olmuştur. Güvenli bir kolesistektomi için birçok teknik ve yaklaşım tanımlansa da Calot üçgeni disseksiyonu önemini korumaktadır. Komplikasyonların önüne geçebilmek için normal anatominin yanı sıra varyasyonlar da tanınmalı ve akılda tutulmalıdır. Bu yazıda kliniğimizde ameliyat ettiğimiz hastalarda karşılaştığımız sağ hepatik arterin tırtıl hörgücü (caterpillar hump) varyasyonunu sunmayı amaçladık.

Keywords

Sağ hepatik arter, Varyasyon, Laparaskopi, Kolesistektomi, Tırtıl Hörgücü, Moynihan Hump

References

• Traverso LW. Carl Langenbuch and the first cholecystectomy. Am J Surg. 1976;132(1):81-2. DOI: 10.1016/0002-9610(76)90295-6.
• Langenbuch C. Ein Ruckblick auf die Entwicklung der Chirurgie des Gallensystems. Verhandlungen der Deutschen Gesselschaft fur Chirurgie. 1986;68.
• Morgenstern L. Carl Langenbuch and the first cholecystectomy. Surg Endosc. 1992;6(3):113-4. DOI: 10.1007/BF02309080.
• Lukichev OD, Filimonov MI, Zybin IM. Metodika laparoskopicheskoĭ kholetsistostomii [A method of laparoscopic cholecystostomy]. Khirurgiia (Mosk). 1983;(8):125-7. Russian.
• Muhe E. Die erste cholezystektomie durch das laparoscop. Langenb Arch Klin Chir. 1986;369:804.
• Akçakaya A, Hatipoğlu E, Kartal E, Yaprak E. Güvenli Kolesistektomi. Türkiye Klinikleri J Gen Surg-Topics. 2014;7:11.
• Michels NA. Newer anatomy of the liver and its variant blood supply and collateral circulation. Am J Surg. 1966;112(3):337-47.DOI: 10.1016/0002-9610(66)90201-7 Andall RG, Matusz P, du Plessis M, Ward R, Tubbs RS, Loukas M. The clinical anatomy of cystic artery variations: a review of over 9800 cases. Surg Radiol Anat. 2016;38(5):529-39. DOI: 10.1007/s00276-015-1600-y.
• Moosman DA. The surgical significance of six anomalies of the biliary duct system. Surg Gynecol Obstet. 1970;131(4):655-60.
• Andall RG, Matusz P, du Plessis M, Ward R, Tubbs RS, Loukas M. The clinical anatomy of cystic artery variations: a review of over 9800 cases. Surg Radiol Anat. 2016;38(5):529-39. DOI: 10.1007/s00276-015-1600-y.
• Johnston EV, Anson BJ. Variations in the formation and vascular relationships of the bile ducts. Surg Gynecol Obstet. 1952;94(6):669-86.
• Benson EA, Page RE. A practical reappraisal of the anatomy of the extrahepatic bile ducts and arteries. Br J Surg. 1976;63(11):853-60. DOI: 10.1002/bjs.1800631105.
• Bergamaschi R, Ignjatovic D. More than two structures in Calot’s triangle. A postmortem study. Surg Endosc. 2000;14(4):354-7. DOI: 10.1007/s004640000154.
• Ayyaz M, Fatima T, Ahmed G. Arterial anatomy in Calot’s triangle as viewed through the laparoscope. Ann King Edward Med Coll. 2001;7:183–185. DOI:10.21649/akemu.v7i3.1851
• Hamza MU, Jaffar AA, Hassan HA, et al. Vascular and gall bladder variations inlaparoscopic cholecystectomy. Med J Babylon. 2008;5(1):119–130.
• Al-Sayigh HA. The incidence of cystic artery variation during laparoscopic surgery. Med J Babylon. 2010;7:389–403.
• Mishall PL, Rajgopal L. Variant right hepatic artery forming Moynihan’s hump –clinical relevance. Int J Anat Var. 2010;3:144–145.
• Jansirani D, Mugunthan N, Phalgunan V, et al. Caterpillar hump of right hepatic artery: incidence and surgical significance. Natl J Clin Anat. 2012;1(3):121–124
• Dawani S, Sandhya A, Rasul S, et al. Frequency of common anatomical variations in the extrahepatic biliary tract in patients undergoing elective cholecystectomy. Pak J Surg. 2013;29(1):61–65.
• Kamath BK. An anatomical study of Moynihan’s hump of right hepatic artery and its surgical importance. Journal of the Anatomical Society of India. 2016:65;65-67,DOI:10.1016/j. jasi.2016.04.004.
• Abbasoğlu O, Tekant Y, Alper A, et al. Prevention and acute management of biliary injuries during laparoscopic cholecystectomy: Expert consensus statement. Ulus Cerrahi Derg. 2016;32(4):300-305. DOI: 10.5152/UCD.2016.3683.