LAPAROSCOPIC STUDY OF HEPATOBILLIARY TRIANGLE AND ITS VARIATIONS IN PAKISTAN

Abstract

Objective: To assess frequency of the anatomical variations of boundries and contents of Hepatobiliary triangle using a laparoscope Study design: It was a descriptive cross-sectional study. Place and duration of study: This research work was undertaken in five teaching hospitals with required facilities and skillfull surgical team, from 8th Jan 2011-15th Jan 2014. Methadology: convenient non-probabilty sampling technique was employed. This study was prospective evaluation of 500 patients ,including 350 women and 150 men, who underwent exploration of Hepatobiliary Triangle during laparoscopic cholecystectomy for different gallbladder diseases.Amongstthem388 patients with cholecystitis due to gallstones, and 112 with other gallbladder diseases like polyps, were analysed Results: We documented variations in cystic artery-21%, cystic duct-18%, cystic lymph nodes-47%. Comparison and correlation of findings in male and female patients was made. Fat, fibrosis, adhesions was present more in Hepatobiliary triangles of female patients. No other differences were found between the sexes. Conclusion: Laparoscopic surgeons must know variant anatomy of Hepatobiliary Triangle to avoid intraoperative damage to the blood vessels and the extrabiliary apparatus during Laparoscopic cholecystectomy.