The cystohepatic triangle (or hepatobiliary triangle) is an anatomic space bordered by the cystic duct inferiorly, the

common hepatic duct The common hepatic duct is the first part of the biliary tract. It joins the cystic duct coming from the gallbladder to form the common bile duct. Structure The common hepatic duct is the first part of the biliary tract. It is formed by the ...

medially, and the inferior surface of the

liver The liver is a major Organ (anatomy), organ only found in vertebrates which performs many essential biological functions such as detoxification of the organism, and the Protein biosynthesis, synthesis of proteins and biochemicals necessary for ...

superiorly. The

cystic artery The cystic artery (also known as bachelor artery) supplies oxygenated blood to the gallbladder and cystic duct. Most common arrangement In the classic arrangement, occurring with a frequency of approximately 70%, a singular cystic artery originat ...

lies within the hepatobiliary triangle, which is used to locate it during a

laparoscopic Laparoscopy () is an operation performed in the abdomen or pelvis using small incisions (usually 0.5–1.5 cm) with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few small cuts in the abdomen.Medli ...

cholecystectomy Cholecystectomy is the surgical removal of the gallbladder. Cholecystectomy is a common treatment of symptomatic gallstones and other gallbladder conditions. In 2011, cholecystectomy was the eighth most common operating room procedure performed i ...

Structure

The hepatobiliary triangle is the area bound by the: * cystic duct inferiorly. *

medially. * inferior margin of the

superiorly.Schwartz's Manual of Surgery BRUNICARDI C.F 10th edition It is covered in peritoneum both anteriorly and posteriorly. It contains the

and cystic

lymph node A lymph node, or lymph gland, is a kidney-shaped organ of the lymphatic system and the adaptive immune system. A large number of lymph nodes are linked throughout the body by the lymphatic vessels. They are major sites of lymphocytes that inclu ...

s. The

right hepatic artery The hepatic artery proper (also proper hepatic artery) is the artery that supplies the liver and gallbladder. It raises from the common hepatic artery, a branch of the celiac artery. Structure The hepatic artery proper arises from the common h ...

may also pass through the hepatobiliary triangle.

Clinical significance

General surgeons frequently quiz medical students on this term and the name for the lymph node located within the triangle, Mascagni's lymph node or

Lund's node Lund's node, or Mascagni's lymph node (often erroneously referred to as Calot's node), is the sentinel lymph node of the gall bladder. It increases in size in cholecystitis and cholangitis. It is an anatomic landmark and is removed along with the g ...

, however many often erroneously refer to it as "Calot's node". The latter is frequently enlarged due to inflammation of the gallbladder (e.g.

cholecystitis Cholecystitis is inflammation of the gallbladder. Symptoms include right upper abdominal pain, pain in the right shoulder, nausea, vomiting, and occasionally fever. Often gallbladder attacks (biliary colic) precede acute cholecystitis. The pain l ...

) or the biliary tract (e.g. cholangitis) and may be removed along with the gallbladder during surgical treatment (

). The

lies within the hepatobiliary triangle, which is used to locate it during a

. It may also contain an accessory

or an 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 most common cause of common bile duct injuries.

History

Another name used to refer to the hepatobiliary triangle is Calot's triangle, after Jean-François Calot.J. F. Calot. De la cholécystectomie. Doctoral thesis, Paris, 1891. 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).

References

6. Bailey & Love's Short Practice of Surgery 26th edition (see page 1098). {{Authority control Abdomen Hepatology