Makindo Medical Notes

Calot's triangle, also known as the cystohepatic triangle, is an important anatomical region located in the upper right quadrant of the abdomen. It is a critical area in hepatobiliary surgery, particularly during cholecystectomy (removal of the gallbladder), because of its proximity to key structures.

Boundaries of Calot's Triangle

• Medial Boundary: The common hepatic duct.
• Lateral Boundary: The cystic duct.
• Superior Boundary: The inferior surface of the liver (often referred to as the cystic artery in surgical contexts).

Contents of Calot's Triangle

• Cystic Artery: The artery that supplies blood to the gallbladder. It is typically the most important structure found within Calot's triangle.
• Lymph Nodes: Often referred to as the lymph node of Lund, located within the triangle.
• Accessory Structures: Occasionally, accessory bile ducts or arteries may be present within the triangle.

Clinical Significance

• Cholecystectomy: During gallbladder removal, surgeons carefully dissect within Calot's triangle to identify and ligate the cystic artery and duct safely, while avoiding injury to the common bile duct and other vital structures.
• Variations in Anatomy: Anatomical variations in the structures within Calot's triangle are common. Knowledge of these variations is crucial to avoid complications during surgery.
• Bile Duct Injuries: Inadvertent injury to the common bile duct or other structures within the triangle can lead to significant complications, making careful identification and dissection essential.
• Inflammation and Scarring: In cases of severe inflammation, such as in acute cholecystitis, the anatomy of Calot's triangle may be distorted, increasing the risk of surgical complications.

History

Calot's triangle was first described by the French surgeon Jean-François Calot in 1891. Initially, it was defined differently, with the cystic artery forming the superior boundary. However, the modern understanding of Calot's triangle as the cystohepatic triangle is more widely accepted in contemporary surgical practice.

Summary

Calot's triangle is a vital anatomical area in hepatobiliary surgery, particularly during procedures like cholecystectomy. Understanding its boundaries, contents, and potential variations is crucial for surgeons to perform safe and effective surgeries while minimizing the risk of complications.