“Several risk factors may contribute to vascular injuries during laparoscopic cholecystectomy: Anatomical factors, including vascular anomalies, patient-related factors, the gallbladder pathology and surgeon’s experience. Concerning the anatomical factors, the different variants of vascular anatomy may represent a possible cause of bile duct injuries, particularly anomalies of the cystic artery and right hepatic artery (RHA). If surgeons are not aware of possible variations of the RHA, such as in the case of acute and chronic cholecystitis with unclear anatomy of Calot’s triangle, the RHA may be accidentally injured or mistaken for the cystic artery and actively cut off”

“Vascular injuries represent a life-threatening complication, and they should be carefully evaluated along with biliary lesions during laparoscopic cholecystectomy. The recognition of these lesions must occur as early as possible, and the surgeon must choose the best therapeutic option for the patient according to available medical resources. Currently, the management of referrals to specialized hepato-biliary centers for multidisciplinary approaches is mandatory.”

Pesce A, et al Vascular injury during laparoscopic cholecystectomy: An often-overlooked complication. World J Gastrointest Surg. 2023 Mar 27;15(3):338-345. Free Full Text