Hepatobiliary triangle
Encyclopedia
The hepatobiliary triangle (or cystohepatic triangle) is an anatomic space bordered by the common hepatic duct
medially, the cystic duct
inferiorly and the superior border to the cystic artery
.
. 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).
The hepatocystic triangle is the area bound by the cystic duct, common hepatic duct, and the liver margin.
) 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 aberrant / 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 #1 cause of common bile duct injuries.
Common hepatic duct
The common hepatic duct is the duct formed by the convergence of the right hepatic duct and the left hepatic duct . The common hepatic duct then joins the cystic duct coming from the gallbladder to form the common bile duct...
medially, the cystic duct
Cystic duct
The cystic duct is the short duct that joins the gall bladder to the common bile duct. It usually lies next to the cystic artery. It is of variable length...
inferiorly and the superior border to the cystic artery
Cystic artery
-Most common arrangement:In the classic arrangement, occurring with a frequency of approximately 70%, a singular cystic artery originates from the geniculate flexure of the right hepatic artery in the upper portion of the hepatobiliary triangle...
.
Eponym
Another name used to refer to this region is Calot's Triangle. It is named for Jean-François CalotJean-François Calot
Jean-François Calot was a French surgeon best known for describing treatment of curvature of the spine in Pott's disease. He also described a method of treating tuberculous abscesses and defined Calot's triangle....
. 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).
The hepatocystic triangle is the area bound by the cystic duct, common hepatic duct, and the liver margin.
Clinical significance
General surgeons frequently quiz medical students on this term and the name for the lymph node located within the triangle, Calot's node. The latter is frequently enlarged due to inflammation of the gallbladder (e.g. cholecystitisCholecystitis
-Signs and symptoms:Cholecystitis usually presents as a pain in the right upper quadrant. This is known as biliary colic. This is initially intermittent, but later usually presents as a constant, severe pain. During the initial stages, the pain may be felt in an area totally separate from the site...
) or the biliary tract (e.g. cholangitis) and may be removed along with the gallbladder during surgical treatment (cholecystectomy
Cholecystectomy
Cholecystectomy is the surgical removal of the gallbladder. It is the most common method for treating symptomatic gallstones. Surgical options include the standard procedure, called laparoscopic cholecystectomy, and an older more invasive procedure, called open cholecystectomy.-Open surgery:A...
).
Calot's triangle, containing the cystic artery, may also contain an aberrant / 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 #1 cause of common bile duct injuries.