Anatomical Variations of the Cystic Artery among Sudanese Populations in Khartoum State – Sudan

Misinterpretation of the anatomical variations in the origin of cystic artery can contribute to a major intraoperative and postoperative surgical complications during cholecystectomy, the incidence being higher with laparoscopic cholecystectomy. The topographical anatomy of the arterial system of hepatobiliary region and their anomalous origin should be considered during surgeries and interventional radiology in routine clinical practice to minimize invasive surgical errors. The cystic artery is recognized for its variable origin and branching pattern. When it arises from an artery other than its most common origin, its relationship to adjacent structures and Calot’s triangle can be affected. The data in this study was collected by careful observation of the biliary blood supply focusing on the cystic artery origins in relation to Calot’s triangle from the available dissected cadavers in Khartoum University and images from radiologic centers in Khartoum state using transabdominal doppler ultrasound imaging and CT angiography together with questionnaires. All the collected data was analyzed using SPSS program. Then the results were compared with relevant studies. In this study a total of 48 subject (44 males and 4 female) were included for cadaveric and radiological images. Most of the subjects were between 40 to 60 years old. All subjects in this study were within Calot’s triangle, with no sample outside this area. The major primary origin of the cystic artery in 45 subjects (93.8 %) was the right hepatic artery, while in three subjects (6.2 %) it originated from the left hepatic artery. A double cystic artery was observed in five samples (10.4%). No arteries were found originating from the gastroduodenal artery, superior mesenteric artery or any other source. This study is one of the limited research projects conducted on Sudanese individuals and its findings cannot be extended to all Africans.