Year: 2026 | Month: June | Volume: 16 | Issue: 6 | Pages: 229-237
DOI: https://doi.org/10.52403/ijhsr.20260626
Anatomical Variability of Cystic Artery Position During Laparoscopic Cholecystectomy: An Observational Study in North-East India
Abhirami P P1, Nilotpal Chakma2, Nazaru Debbarma3, Tapash Rudra Paul4, Bhupendra Kumar Sahu5, Debraj Datta Choudhury6
1Post Graduate Trainee, Department of General Surgery,
Agartala Government Medical College & Govind Ballav Pant Hospital, Tripura, India.
2Professor, Department of General Surgery,
Agartala Government Medical College & Govind Ballav Pant Hospital, Tripura, India.
3Senior Resident, Department of General Surgery, Agartala Government Medical College & Govind Ballav Pant Hospital, Tripura, India.
4Assistant Professor, Department of General Surgery, Agartala Government Medical College & Govind Ballav Pant Hospital, Tripura, India.
5Post Graduate Trainee, Department of General Surgery, Agartala Government Medical College & Govind Ballav Pant Hospital, Tripura, India.
6Post Graduate Trainee, Department of General Surgery, Agartala Government Medical College & Govind Ballav Pant Hospital, Tripura, India.
Corresponding Author: Dr. Abhirami P P
ABSTRACT
Background: Anatomical variability of the cystic artery within Calot’s triangle poses a significant risk during laparoscopic cholecystectomy (LC), potentially leading to vascular injury, uncontrolled haemorrhage, and conversion to open surgery.
Objective: To document the anatomical positions of the cystic artery among patients undergoing LC in North‑East India and assess their clinical relevance.
Methods: A prospective observational study was conducted from June 2024 to November 2025. Intraoperative findings of 141 patients undergoing LC were systematically recorded, focusing on cystic artery position, associated variations, and radiological features.
Results: The cystic artery was most commonly superomedial to the cystic duct (82.3%). Variations included superolateral (9.9%), posterolateral (3.5%), anterior (2.1%), and double cystic artery (1.4%). Radiological findings revealed increased gallbladder wall thickness in 17.7% and pericholecystic fluid in 14.2%, both indicative of acute inflammatory changes. Most patients were female (76.6%) and aged 21–40 years (51.8%). Comorbidities were uncommon, with hypertension (12.8%) and diabetes (7.1%) being the most frequent.
Conclusion: While the superomedial course of the cystic artery predominates, nearly one‑fifth of patients exhibit variations that increase operative difficulty. Awareness of these patterns is essential for safe dissection, prevention of vascular injury, and reduction of conversion rates.
Key words: Cystic artery, anatomical variation, laparoscopic cholecystectomy, Calot’s triangle, vascular injury, gallstone disease