Nabeel Qamar, Abdul Jabbar Mirani, Saeed Ahmad, Khalida Parveen, Naheed Sultan.
Lymph node significance in cystic artery identification during Laparoscopic Cholecystectomy.
Pak J Surg Jan ;30(2):180-2.

Objective: To assess the frequency of cystic lymph node within the Calot’s triangle and to identify the relation of Cystic artery with cystic lymph node. Study design: Cross Sectional study. Place and Duration: Th is study was done at the department of surgery Dow University of Health Sciences (DUHS) and civil hospital Karachi from September 2011 to April 2013 (series 2). Methodology: Non probability, purposive sampling technique was used for sample collection. Th e samples were 300 diagnosed cases of Cholelithiasis, undergoing Laparoscopic Cholecystectomy in Civil Hospital Karachi and other private hospitals of Karachi. Laparoscopic Cholecystectomy was performed under general anesthesia using the four port technique. Th e information of anatomy on endoscopic visualization was recorded by DVD recorder aft er taking the informed consent of the patient. Over all frequencies of cystic lymph node were noted and the relation of it were identifi ed with cystic artery. Results: SPSS (version 16) was used in the analysis. Overall frequencies of the cystic lymph node and relations of the variation were noted. Out of 300 cases there were 53.33% cases having a lymph node in Calot’s triangle and 46.67% (n=140) cases with no lymph node in the Calot’s triangle. Out of 160 cases with lymph node, there were 40.6% cases with a cystic artery anterioinferior to the lymph node and 59.4% cases having cystic artery posterioinferior to the lymph node Conclusion: We found cystic lymph node in more than half of the cases. We also found a signifi cant relation of the node with the cystic artery. Surgeons can use the lymph node as a landmark for the identifi cation and clipping of the cystic artery. Th is information will be helpful in the safe procedure of the laparoscopic cholecystectomy.

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