The cystohepatic triangle (or hepatobiliary triangle or Calot's triangle) is an

anatomic space {{set index article In anatomy, a spatium or anatomic space is a space (cavity or gap). Anatomic spaces are often landmarks to find other important structures. When they fill with gases (such as air) or liquids (such as blood) in pathological ways, ...

bordered by the

cystic duct The cystic duct is the duct that (typically) joins the gallbladder and the common hepatic duct; the union of the cystic duct and common hepatic duct forms the bile duct (formerly known as the common bile duct). Its length varies. Anatomy ...

laterally, 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 metabolic organ (anatomy), organ exclusively found in vertebrates, which performs many essential biological Function (biology), functions such as detoxification of the organism, and the Protein biosynthesis, synthesis of var ...

superiorly. Cystohepatic triangle

The

cystic artery The cystic artery (also known as bachelor artery) is (usually) a branch of the right hepatic artery that provides arterial supply to the gallbladder and contributes arterial supply to the extrahepatic bile ducts. Anatomy The cystic artery usually ...

lies within the hepatobiliary triangle. The triangle is used to locate the cystic artery during a

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

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 bounded by the: *

inferiorly *

medially * inferior margin of the

superiorlySchwartz's Manual of Surgery BRUNICARDI C.F 10th edition It is covered in

peritoneum The peritoneum is the serous membrane forming the lining of the abdominal cavity or coelom in amniotes and some invertebrates, such as annelids. It covers most of the intra-abdominal (or coelomic) organs, and is composed of a layer of mesotheli ...

both

anteriorly Standard anatomical terms of location are used to describe unambiguously the anatomy of humans and other animals. The terms, typically derived from Latin or Greek language, Greek roots, describe something in its standard anatomical position. Thi ...

and

posteriorly Standard anatomical terms of location are used to describe unambiguously the anatomy of humans and other animals. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position provi ...

The triangle contains:

adipose Adipose tissue (also known as body fat or simply fat) is a loose connective tissue composed mostly of adipocytes. It also contains the stromal vascular fraction (SVF) of cells including preadipocytes, fibroblasts, Blood vessel, vascular endothel ...

and connective tissue,

lymphatic vessels The lymphatic vessels (or lymph vessels or lymphatics) are thin-walled vessels (tubes), structured like blood vessels, that carry lymph. As part of the lymphatic system, lymph vessels are complementary to the cardiovascular system. Lymph vessel ...

and the cystic lymph node,

autonomic nerves Autonomic can refer to: *Autonomic nervous system, a division of the peripheral nervous system that supplies smooth muscle and glands, and thus influences the function of internal organs *Autonomic computing Autonomic computing (AC) is distribute ...

, (usually)

, and (sometimes) an accessory cystic duct. 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

The anatomy and variant anatomy of this region is important during

gallbladder In vertebrates, the gallbladder, also known as the cholecyst, is a small hollow Organ (anatomy), organ where bile is stored and concentrated before it is released into the small intestine. In humans, the pear-shaped gallbladder lies beneath t ...

removal to prevent

iatrogenic Iatrogenesis is the causation of a disease, a harmful complication, or other ill effect by any medical activity, including diagnosis, intervention, error, or negligence." Iatrogenic", ''Merriam-Webster.com'', Merriam-Webster, Inc., accessed 27 ...

injury to the

bile duct A bile duct is any of a number of long tube-like structures that carry bile, and is present in most vertebrates. The bile duct is separated into three main parts: the fundus (superior), the body (middle), and the neck (inferior). Bile is requ ...

, or

. 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 The American College of Surgeons (ACS) is a professional medical association for surgeons and surgical team members, founded in 1913. It claims more than 90,000 members in 144 countries. History The ACS was founded in 1913 as an outgrowth of ...

) 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 Jean-François Calot (17 May 1861 – 1 March 1944) was a French surgeon best known for describing treatment of curvature of the spine in Pott's disease. He also described a method of treating tuberculous abscesses and defined Calot's triangle. ...

.J. F. Calot. De la cholécystectomie. Doctoral thesis, Paris, 1890. Calot's original description of the triangle in 1890 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

Structure

Contents

Clinical significance

History

References