Double Cystic Artery Arising from the Right Hepatic Artery During Laparoscopic Cholecystectomy: A Case Report

Abstract

Anatomical variations of the cystic artery are frequently encountered during laparoscopic cholecystectomy and, if not properly identified, may increase the risk of intraoperative complications. Among these, the occurrence of a double cystic artery is an uncommon yet clinically significant variation that warrants careful recognition during surgical procedures. We report the case of a 52-year-old female patient who underwent elective laparoscopic cholecystectomy for symptomatic cholelithiasis. Preoperative ultrasonography revealed multiple millimetric gallstones within the gallbladder, and laboratory findings were within normal limits. During dissection of Calot’s triangle, two distinct cystic arteries originating from the right hepatic artery were identified. After achieving the critical view of safety, both arteries were individually clipped with two clips and divided. The procedure was completed laparoscopically without complications. The patient was discharged on postoperative day one, and histopathological examination revealed chronic cholecystitis. Awareness of cystic artery variations is essential to prevent intraoperative bleeding and ensure safe laparoscopic cholecystectomy.