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Gallbladder Pathology Online

Arterial and Lymphatic supply of the Gallbladder

Dr Sampurna Roy MD    

 

Arterial supply of the Gallbladder

The cystic artery, a branch of the right hepatic artery is usually given off behind the common hepatic duct.

Thus it makes the base of Calot’s triangle, the other sides being the right hepatic artery above, and the cystic duct below.

Occasionally an accessory cystic artery arises from the gastro-duodenal artery.

In 15% of cases the right hepatic artery and/or the cystic artery cross in front of the common bile duct and the cystic duct.

The most dangerous anomaly of all is when the hepatic artery takes a tortuous course in front of the origin of the cystic duct or the right hepatic artery is tortuous, and the cystic artery is short.

The tortuosity is known as the ‘caterpillar turn’ or Moynihan’s hump.

There is a possibility of liver infartion in accidental ligation of  the common hepatic artery, but chances of recovery in this and right  hepatic ligation are improved by giving neomycin or ampicillin by mouth, and ensuring a high  intake of glucose.

Hyperbaric oxygen would be useful, if available.

Infarction in a jaundiced patient is probably lethal.

Lymphatic supply of the Gallbladder

The lymph vessels of the gallbladder (subserosal and submucous), drain into the cystic lymph nodes of Lund (the sentinel lymph node), which lies in the fork created by the junction of the cystic and common bile ducts.

Efferent vessels from this lymph node go to the hilum of the liver, and to the celiac lymph nodes.

The subserosal lymphatic vessels of the gallbladder also connect with the subcapsular lymph channels of the liver, and this accounts for the frequent spread of carcinoma of the gallbladder to the right lobe of the liver.

 

 

 

 

 

 

 

          

 

 

 

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