International Surgery Journal | September 2020 | Vol 7 | Issue 9 Page 2837 International Surgery Journal Akay T et al. Int Surg J. 2020 Sep;7(9):2837-2842 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Original Research Article Incidence of double cystic artery: a clinical study Tamer Akay 1 *, Metin Leblebici 2 INTRODUCTION Success and safety in laparoscopic cholecystectomy are related to the importance given to the knowledge about general embryological anomalies of the biliary tract. Blood flow, ductal variations, and gallbladder anatomy of this region are the major source of difficulty for surgeons. The understanding of cystic artery anatomy and variations may reduce complications such as uncontrolled intraoperative bleeding and extrahepatic biliary injury, thereby reducing the possibility of development to open cholecystectomy. 1 The cystic artery originates by taking 1-3 branches from the hepatic artery and is located within Calot's triangle. 2 The cystic artery shows a high degree of variation. This condition can be seen not only in its origin or number but also in its branches leading to the gallbladder (Figure 1). Regardless of the number and origin, the importance during gallbladder surgery lies in connecting the cystic artery. 3 The aim of this study was to become familiar with vascular variations in laparoscopic cholecystectomy. ABSTRACT Background: A successful laparoscopic cholecystectomy is associated with the knowledge about anatomic structures and the congenital anomaly of the biliary tract. The aim of this study was to become familiar with vascular variations in laparoscopic cholecystectomy. Methods: This was a retrospective clinical study. The files of patients who underwent laparoscopic cholecystectomy due to benign gallbladder diseases were analyzed. The characteristics and complications of the patients with double cystic artery were recorded and examined. Results: A total of 360 patients, 76 males and 284 females were included in the study. The mean age was 51.2 (25- 81). When the files of the patients were examined, it was found that double cystic arteries were detected during the operation in two male (2.63%) and nine female patients (3.16%). Gall bladder polyp was found as an indication for operation in one of 11 patients, while multiple gallbladder stones were found as an indication for operation in the other patients. The laparoscopic cholecystectomy was converted to conventional cholecystectomy in two from 11 patients (18.1%) with double cystic arteries due to bleeding. The mean duration of hospital stay in the patients with double cystic artery is 5.2 (3-11) days, and (2.7 days) longer compared to the patients without a double cystic artery. Conclusions: Cystic artery variations and other variations can coexist. Awareness of cystic artery variations can reduce the possibility of uncontrolled intraoperative bleeding, extrahepatic biliary injury, and switching to conventional cholecystectomy. Keywords: Cholecystectomy, Cystic artery, Variation 1 Department of General Surgery,Bandirma State Hospital, Balikesir, Turkey 2 Department of General Surgery, Medeniyet University Medical Faculty Hospital, Istanbul, Turkey Received: 09 July 2020 Revised: 25 July 2020 Accepted: 28 July 2020 *Correspondence: Dr. Tamer Akay, E-mail: op.dr.tamerakay@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-2902.isj20203499