Cystohepatic triangle

Cystohepatic triangle
The cystic artery branches from the right hepatic artery.
Relationship to other vessels.
Details
Identifiers
Latin	trigonum cystohepaticum
Dorlands /Elsevier	t_17/12820863
TA	A10.1.02.428
FMA	24230
*Anatomical terminology*

The hepatobiliary triangle (or cystohepatic triangle) is an anatomic space bordered by the cystic duct inferiorly, common hepatic duct medially and the inferior (visceral) surface of the cystic artery superiorly. ^[1] The cystic artery lies within the cystohepatic triangle, which is used to locate it during a laparoscopic cholecystectomy. ^[2]

Eponym

Another name used to refer to this region is Calot's Triangle. It is named for Jean-François Calot.^[3]^[4] Of note, Calot's original description of the triangle in 1891 included the cystic duct, the common hepatic duct, and the cystic artery (not the inferior border of the liver as is commonly believed).^[1] The Hepatocystic triangle is the area bound by the cystic duct, common hepatic duct, and the liver margin.^[5]

Clinical significance

General surgeons frequently quiz medical students on this term and the name for the lymph node located within the triangle, Mascagni's lymph node or Lund's node, however many often erroneously refer to it as "Calot's node." The latter is frequently enlarged due to inflammation of the gallbladder (e.g. cholecystitis) or the biliary tract (e.g. cholangitis) and may be removed along with the gallbladder during surgical treatment (cholecystectomy).

Calot's triangle, containing the cystic artery, may also contain an accessory right hepatic artery or anomalous sectoral bile ducts. As a result dissection in the triangle of Calot is ill-advised until the lateral-most structures have been cleared and identification of the cystic duct is definitive. According to SESAP 12 (produced and distributed by the American College of Surgeons) dissection in the triangle of Calot is the most common cause of common bile duct injuries.

References

1 2 Haubrich WS (2002). "Calot of the triangle of Calot". Gastroenterology. 123 (5): 1440. PMID 12404217. doi:10.1053/gast.2002.1231440.
↑ Haubrich, W (November 2002). "Calot of the triangle of Calot". Gastroenterology. 123 (5): 1440. PMID 12404217. doi:10.1053/gast.2002.1231440.
↑ synd/4023 at Who Named It?
↑ J. F. Calot. De la cholécystectomie. Doctoral thesis, Paris, 1891.
↑ Schwartz's Manual of Surgery BRUNICARDI C.F 10th edition

Anatomy of the peritoneum and mesentery

General

Abdominal

From ventral mesentery	Lesser omentum Hepatoduodenal ligament Hepatogastric ligament Liver Coronary ligament (Left triangular ligament Right triangular ligament Hepatorenal ligament) Falciform ligament (Round ligament of liver and Ligamentum venosum in it, but not of it)
From dorsal mesentery	Greater omentum Gastrophrenic ligament Gastrocolic ligament Gastrosplenic ligament Mesentery Splenorenal ligament Phrenicocolic ligament Folds Umbilical folds Supravesical fossa Medial inguinal fossa Lateral umbilical fold Lateral inguinal fossa Ileocecal fold
Abdominal cavity	Greater sac Lesser sac Omental foramen
General	Cystohepatic triangle Hepatorenal recess of subhepatic space Abdominal wall Inguinal triangle Peritoneal recesses Paracolic gutters Paramesenteric gutters

Pelvic

Uterus/ovaries	Broad ligament of the uterus Mesovarium Mesosalpinx Mesometrium) Ovarian ligament Suspensory ligament of ovary
Recesses	Male Recto-vesical pouch Pararectal fossa Female Recto-uterine pouch Recto-uterine fold (Uterosacral ligament) Vesico-uterine pouch Ovarian fossa Paravesical fossa Retroperitonium

Spaces

6. Bailey & Love's Short Practice of Surgery 26th edition (see page 1098).

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