Variations of Cystic Artery as Viewed During Laparoscopic Cholecystectomy: A Review of 400 Cases from Pakistan in Light of Ding's Classification

Abstract

Objective: To evaluate the variations of cystic artery during laparoscopic cholecystectomy.
Methods: The studywas conducted in ServicesHospitalLahore from1stJanuary, 2018 to 31stDecember, 2019. Aftertaking approvalfromhospital ethical committee 400 patientsfulfilling the inclusion criteriawere recruited  from OPD of Department of Surgery, Services Hospital, Lahore. Informed consent was taken and demographic information (name, age, sex, contact) was obtained. All cases in the study were operated under general anesthesia by a single surgical team. Anatomy of the Calot's triangle was noted as per the proposed classification by Ding the findings were noted and classified. The data was entered in SPSS version 20 and was analyzed through it. Mean and standard deviation were calculated for age. Frequency and percentage were calculated for gender and variation of cystic artery. Data was stratified for male and female. Variation of cystic artery was compared in both genders by using chi-square test taking p-value<0.05 as significant.
Results: Out of 400 patients included in our study Group 1 (cystic artery in the Calot's Triangle) was seen in 84.75% (339/400), Group 2 (Cystic artery found outside the Calot's Triangle ) in 14 %( 57/400) and Group 3 (compound type) in only 1 %( 4/400) which is similar to the original observations by Ding in their study of 600 cases with 85.5% patients being in Group 1 , 13% in Group 2 13% and 1.5% in Group 3.
Conclusion: On the basis of our results we conclude that the classification proposed by Ding is valid in our patients undergoing laparoscopic cholecystectomy