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Information about Cystic Artery

Artery: Cystic artery
The cystic artery branches from the hepatic artery proper.
Relationship to other vessels. (Note that relationships are highly variable -- see below.)
Latinarteria cystica
subject #154 605
SuppliesGall bladder and cystic duct
SourceRight hepatic artery
BranchesSuperior branch
Deep branch
VeinCystic vein
Dorlands/Elsevier a_61/12154087
The cystic artery supplies oxygenated blood to the gallbladder and cystic duct.

Most common arrangement

In the classic arrangement, occurring with a frequency of approximately 70%, a singular cystic artery originates from the geniculate flexure of the right hepatic artery in the upper portion of the hepatobiliary triangle [1]. A site of origin from a more proximal or distal portion of the right hepatic artery is also considered relatively normal.

After separating from the right hepatic artery, the cystic artery travels superiorly to the cystic duct and produces 2 to 4 minor branches, known as Calot’s arteries, that supply part of the cystic duct and cervix of the gallbladder before dividing into the major superficial and deep branches at the superior aspect of the gallbladder neck:
  • The superficial branch (or anterior branch) passes sub-serously over the left aspect of the gallbladder.
  • The deep branch (or posterior branch) runs between the gallbladder and gallbladder fossa, terminating at the peritoneum attached to the liver surface.

Anatomic variation

Double cystic artery

When superficial and deep branches of the cystic artery do not share a common origin it is defined as a double cystic artery occurring with a frequency of 15%.

The deep branch consistently arises from the right hepatic artery which is generally also the source of origin of the superficial branch, however in some cases it has been found to initiate from the anterior segmental artery, middle hepatic artery, left hepatic artery, superior mesenteric artery, gastroduodenal artery or retroduodenal artery.

Approximately half of superficial cystic arteries have been shown to enter through the hepatobiliary triangle, while deep cystic arteries are often quite small in length and diameter. Tripling of the cystic artery is very rare, occurring in between 0-0.3% of cases.

Aberrant origin of the right hepatic artery

Unusual anatomy of the right hepatic can itself affect the path and form of the cystic artery, with the most frequent variation resulting from an aberrant origin of the right hepatic artery which is described in between 2-16% of cases.

Generally this anomalous source is the superior mesenteric artery or more rarely the abdominal aorta, producing what has been described as a “replacing right hepatic artery”, passing through the hepatobiliary triangle and running posterior and parallel to the cystic duct [2].

Because of the close proximity to the gallbladder to the (replacing) right hepatic artery a “caterpillar” or “Moynihan's” hump may form and this artery generally produces multiple short cystic branches rather than a single cystic artery [3].

Left hepatic artery

The cystic artery can arise from the left hepatic artery, and in such a case it usually travels through a passage of liver parenchyma, approaching the neck of the gallbladder, before bifurcating into ascending (or superior) and descending (or inferior) branches. This situation is found in roughly 1% of cases.

This form of the cystic artery does not pass through the hepatobiliary triangle and has been found located both anteriorly and posteriorly to the common hepatic duct. [1]

Recurrent cystic artery

In less than 1% of patients a form known as a recurrent cystic artery is found – the cystic artery arises from the left hepatic artery and passes through either the cholecystoduodenal or cholecystocolic ligaments (connecting the gallbladder to the duodenum and transverse colon respectively), follows the right edge of the hepatoduodenal ligament, and connects to the fundus of the gallbladder before descending to supply the body and neck.[1]

Low-lying cystic artery

When a single cystic artery arises from gastroduodenal artery it forms a configuration is known as low-lying cystic artery, as it passes inferior to the cystic duct through the cholecystoduodenal ligament, and therefore remains outside the hepatobiliary triangle.[1]

This condition has alternatively been described as an inferior cystic artery and transposition of the cystic artery and duct with a prevalence at approximately 5%.

In 25% of these patients with this course there will be a secondary arterial supply to the gallbladder, with the low-lying artery acting as the equivalent of the posterior branch.[3]

Clinical significance

It must be identified and ligated in operations that remove the gallbladder (cholecystectomies).

References

1. ^ Balija M, Huis M, Nikolic V, Stulhofer M. Laparoscopic visualization of the cystic artery anatomy. World J Surg. 1999 Jul;23(7):703-7. PMID 10390590
2. ^ Mlakar Bostjan, Gadzijev Eldar M, Ravnik Dean, Hribernik Marija. Anatomical Variations of the Cystic Artery. Eur J Morph. 2003; 41: 31-34. PMID 15121546
3. ^ Hugh Thomas B, Kelly Michael D, Li Bei. Laparoscopic Anatomy of the Cystic Artery. Am J Surg. 1992; 163: 393-395. PMID 1534464
4. ^
5. ^
6. ^
7. ^

External links

The hepatic artery proper (also proper hepatic artery), arises from the common hepatic artery and joins the portal vein and the common bile duct to form the portal triad.
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Latin}}} 
Official status
Official language of: Vatican City
Used for official purposes, but not spoken in everyday speech
Regulated by: Opus Fundatum Latinitas
Roman Catholic Church
Language codes
ISO 639-1: la
ISO 639-2: lat
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The gallbladder (or cholecyst, sometimes gall bladder) is a pear-shaped organ that stores about 50 ml of bile (or "gall") until the body needs it for digestion.
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The cystic duct is the short duct that joins the gall bladder to the common bile duct. It usually lies next to the cystic artery. It is of variable length. It contains a 'spiral valve', which does not provide much resistance to the flow of bile.
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Hepatic artery can refer to:
  • Common hepatic artery (a branch of the celiac artery)
  • Hepatic artery proper (a branch of the common hepatic artery)

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The cystic vein drains the blood from the gall-bladder, and, accompanying the cystic duct, usually ends in the right branch of the portal vein.

External links

  • Fine A (1997).

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Elsevier, the world's largest publisher of medical and scientific literature, forms part of the Reed Elsevier group. Based in Amsterdam, the company has substantial operations in the UK, USA and elsewhere.
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The gallbladder (or cholecyst, sometimes gall bladder) is a pear-shaped organ that stores about 50 ml of bile (or "gall") until the body needs it for digestion.
..... Click the link for more information.
The cystic duct is the short duct that joins the gall bladder to the common bile duct. It usually lies next to the cystic artery. It is of variable length. It contains a 'spiral valve', which does not provide much resistance to the flow of bile.
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The hepatic artery proper (also proper hepatic artery), arises from the common hepatic artery and joins the portal vein and the common bile duct to form the portal triad.
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The hepatobiliary triangle is an anatomic space bordered by the common hepatic duct medially, the cystic duct inferiorly and the liver superiorly. The cystic artery normally passes through the triangle; this anatomic feature is important during laparoscopic cholecystectomies
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The cystic duct is the short duct that joins the gall bladder to the common bile duct. It usually lies next to the cystic artery. It is of variable length. It contains a 'spiral valve', which does not provide much resistance to the flow of bile.
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In human anatomy, the superior mesenteric artery (SMA) arises from the anterior surface of the abdominal aorta, just inferior to the origin of the celiac trunk, and supplies the intestine from the lower part of the duodenum to the left colic flexure and the pancreas.
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In anatomy, the gastroduodenal artery is a small blood vessel in the abdomen.

It supplies blood to the pylorus (distal part of the stomach) and the proximal part of the duodenum.
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Parenchyma is a term used to describe a bulk of a substance. It is used in different ways in animals and in plants.

The term is New Latin, from Greek parenkhuma, visceral flesh, from parenkhein, to pour in beside : para-, beside + en-, in + khein, to pour.
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Bifurcation refers to the main body of one item splitting into two parts.

Bifurcation may also refer to:
  • Bifurcation (law), the division of issues in a trial
  • Bifurcation (accounting),to divide into separate parts or accounts

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The hepatoduodenal ligament is the portion of the lesser omentum extending between the porta hepatis of the liver and the first part of the duodenum.

Running inside it are the following:[1]
  • hepatic artery proper
  • hepatic portal vein
  • bile duct

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Cholecystectomy (/ˌkɔləsɪsˈtɛktəmi/, plural: cholecystectomies,) is the surgical removal of the gallbladder.
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eMedicine is an online clinical medical knowledge base that was founded in 1996 by Scott Plantz and Richard Lavely, two medical doctors. It was sold to WebMD in January 2006.
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State University of New York, abbreviated SUNY (IPA pronunciation: ['suniː]) is a system of public institutions of higher education in New York, United States.
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State University of New York, abbreviated SUNY (IPA pronunciation: ['suniː]) is a system of public institutions of higher education in New York, United States.
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Georgetown University is a private, Jesuit, research university, located in Washington, D.C.'s Georgetown neighborhood. Father John Carroll founded the school in 1789, though its roots extend back to 1634.
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Georgetown University is a private, Jesuit, research university, located in Washington, D.C.'s Georgetown neighborhood. Father John Carroll founded the school in 1789, though its roots extend back to 1634.
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Arteries are muscular blood vessels that carry blood away from the heart.[1] All arteries, with the exception of the pulmonary and umbilical arteries, carry oxygenated blood.

The circulatory system is extremely important for sustaining life.
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Torso is an anatomical term for the central part of the many animal bodies (including that of the human) from which extend the neck and limbs. It is sometimes referred to as the trunk. The torso includes the thorax and abdomen.
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human abdomen (from the Latin word meaning "belly") is the part of the body between the pelvis and the thorax. Anatomically, the abdomen stretches from the thorax at the thoracic diaphragm to the pelvis at the pelvic brim.
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The abdominal aorta is the largest artery in the abdominal cavity. As part of the aorta, it is a direct continuation of descending aorta (of the thorax).

Path

It begins at the level of the diaphragm, crossing it via the aortic hiatus at the vertebral level of T12.
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The celiac artery, also known as the celiac trunk and also spelled as coeliac, is the first major branch of the abdominal aorta and branches from the aorta around the level of the T12 vertebra in humans.
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In human anatomy, the left gastric artery arises from the celiac artery, and runs along the superior portion of the lesser curvature of the stomach. Branches also supply the lower esophagus.
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In anatomy, the splenic artery (in the past called the lienal artery) is the blood vessel that supplies oxygenated blood to the spleen. It branches from the celiac artery, and follows a course superior to the pancreas.
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