A trainee surgeon is performing his/her first cholecystectomy. The area marked with an asterisk in the diagram represents
Calot's triangle
The asterisked area is Calot's triangle (cystohepatic triangle), bounded medially by the common hepatic duct, laterally by the cystic duct and superiorly by the inferior surface of the liver. It contains the cystic artery, the right hepatic artery, the cystic node of Lund and often accessory ducts. Clearing this triangle to obtain the critical view of safety, so that only two structures are seen entering the gallbladder, is the key step in preventing bile duct injury.
Rouviere's sulcus is a cleft on the right lobe marking the plane of the right portal pedicle, an extrahepatic landmark keeping dissection safely anterior, not a triangle. Bismuth lends his name to the classification of hilar cholangiocarcinoma and bile duct strictures, not to a triangle. The node of Lund (Mascagni node) is merely the sentinel node lying within Calot's triangle over the cystic artery, not the whole area.
Key point: Calot's triangle contains the cystic artery; divide no structure until the critical view of safety is achieved.
Important Questions from Hepatobiliary & Pancreatic Surgery
Which among the following are complications of liver trauma?
1. Liver abscess
2. Biliary fistula
3. Portal thrombosis
4. Liver failure
Select the correct answer using the code given below.
Which of the following are local complications of acute pancreatitis?
1. Pseudocyst
2. Pleural effusion
3. Ileus
4. Acute fluid collection
Select the correct answer using the code given below.
Which of the following are risk factors for the development of pancreatic cancer?
1. Cigarette smoking
2. Diabetes mellitus
3. Caucasian ethnicity
4. Male gender
Select the correct answer using the code given below.
Which of the following are options for management of a pancreatic pseu- docyst?
1. Pancreaticoduodenectomy
2. Cystogastrostomy
3. Percutaneous drainage
4. Endoscopic drainage
Select the correct answer using the code given below :
- Which of the following statements regarding hepatic adenomas are correct? 1. They are almost exclusively seen in females aged 25-50 years 2. They are associated with use of oral contraceptive pills 3. They do not have any malignant potential 4. Majority are detected incidentally on imaging Select the correct answer using the code given below :
