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Gallbladder Twins: Do you know the amazing story of the double cystic artery?
In anatomy, the gallbladder's blood supply comes from the cystic artery (also called the Bachelor's artery), a blood vessel that branches primarily from the right hepatic artery. The existence and structure of the cystic artery are not only of great medical significance, but also have many surprising variations. This article will explore in depth the anatomical characteristics, variations, and clinical significance of the cystic artery.
The anatomy of the cystic artery
The cystic artery is usually less than 3 mm in diameter.
In most cases (about 80%), the cystic artery arises from the right hepatic artery. It usually passes behind the common hepatic duct, travels within the hepatobiliary triangle, and lies above the cystic duct. When it reaches the upper part of the gallbladder neck, it divides into superficial and deep branches, which form a network of arteries on the surface of the gallbladder.
Branching structure of the cystic artery
Above the common neck, the cystic artery divides into two major branches: the superficial branch and the deep branch. The superficial branch runs along the left surface of the gallbladder, while the deep branch runs between the gallbladder and the hepatic cystic fossa. The cystic artery, which has 2 to 4 small branches, also supplies the cystic duct and its neck. In addition, the small branches of the cystic artery are also important in the blood supply to the additional extrahepatic bile ducts.
Variations of the cystic artery
Did you know that in some cases, the cystic artery can exist as a double? Bilateral cystic artery is defined when the superficial and deep branches do not originate from the same source, which occurs in 15% of patients. In most cases, the deep branches arise from the right hepatic artery, but in some special cases, they may arise from other arteries, such as the left hepatic artery or the superior mesenteric artery.
About half of the superficial cystic arteries are found to enter the hepatobiliary triangle, whereas the deep cystic artery is usually very short.
Among cases where there are multiple cystic arteries, triple cystic arteries are very rare, with an incidence rate of only 0-0.3%.
Anomalous origin of the right hepatic arteryAnomalous origin of the right hepatic artery may affect the shape and course of the cystic artery. The most common type of variation results from an anomalous origin of the right hepatic artery, which is reported in 2–16% of cases. This is usually from the superior mesenteric artery or, less commonly, the abdominal aorta, allowing the cystic artery to run through the hepatobiliary triangle in an alternative manner.
Clinical significanceIn medical surgery, identification and ligation of the cystic artery must be performed carefully during gallbladder removal (cholecystectomy).
Overall, the variation in the structure of the cystic artery is not only rich, but also has a direct impact on surgical operations, requiring surgeons to have considerable anatomical knowledge to avoid complications during surgery. Do these variations and structural differences also make us think further about the diversity of life and the meaning behind it?
