Anatomical variations of hepatobiliary triangle in patients operated laparoscopically for gallbladder diseases from Lahore and Sahiwal
Anatomical variations of hepatobiliary triangle in patients operated laparoscopically for gallbladder diseases from Lahore and Sahiwal
Anatomical variations of hepatobiliary triangle in patients operated laparoscopically for gallbladder diseases from Lahore and Sahiwal
Mian Azhar Ahmad1†*, Nawab Mohammad Khan2, Asmatullah3
ABSTRACT
This study was conducted in different hospitals of Lahore and Sahiwal on patients who presented with symptomatic gallstones during the period 2011 to 2015. All the patients irrespective of their age, sex, past history of acute cholecystitis and obesity were subjected to Laparoscopic cholecystectomy. Patients’ age was between 18-70 years, gender ratio was 1:3.5 with female dominance, mean operative time 99.6 minutes and patients remained admitted for 1–3days. The procedure was performed successfully in 91% of the cases. In 09% cases, a conversion to standard open cholecystectomy was necessary; the most common cause was unclear anatomy. Laparoscopic cholecystectomy pivots around hepatobiliary triangle. Current study was aimed to assess anatomy of hepatobiliary triangle and its variations in the patients using a laparoscope. It was a descriptive prospective cross-sectional study. Random sampling technique was employed to record the relevant information data. During the course of this study evaluation of 2500 patients, including 2350 women and 150 men, who underwent exploration of hepatobiliary triangle during laparoscopic cholecystectomy for different gallbladder diseases was performed. Total of 63.6% of patients expressed cystic duct, cystic lymph nodes and cystic artery variations. Among them 12% depicted cystic duct variations, 32.2% of patients demonstrated cystic lymph nodes variations and 19.4% of the patients showed cystic artery variations. In addition to variations mentioned above, fat deposition, fibrosis and adhesions were more prevalent in hepatobiliary areas of female patients. Gallbladder disease with stone is much common in female population. It was observed that these variations were found more common in urban as compared to rural population with respective percentages of 66.67% and 60%. Gallbladder disease with stone was found to be much common in the age group between 31-60 years. Laparoscopic surgeons must know variant anatomy of hepatobiliary triangle to avoid intraoperative damage to blood vessels and extrahepatic biliary apparatus during laparoscopic cholecystectomy to prevent postoperative complications.
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