**Abstract**

Substantial knowledge of the arterial supply and its anatomical variations of the gall bladder and liver are important in all the hepatobiliary surgical procedures. The arterial supply of gallbladder called cystic artery (CA) is a vital structure required to get ligated or clipped in the path of laparoscopic cholecystectomy. The possible concerns like intra-operative bleeding or adjoining accidental injuries will almost always be focused on the research consisting of dissection and clipping with cystic artery. Pseudoaneurysm of the cystic artery has additionally been belonging to the presence of acute cholecystitis or pancreatitis. An original supply of CA is usually assessed depending on the existence of hepatic artery variants. Laparoscopic cholecystectomy is really a recent and arduous noninvasive procedure and might even result in substantial unintended effects possibly iatrogenic or in the form of post-procedural complications. The perfect knowledge of anatomy in addition to feasible variation of cystic artery is mandatory. An efficient operative strategy and consciousness are probably the key components with all the results and marginal likelihood of complications, which often can be ultimately attainable. Within this chapter, we have attempted to explore some variations of cystic artery, complications and management.

**Keywords:** cystic artery (CA), laparoscopic cholecystectomy (LC), proper hepatic artery (PHA), right hepatic artery (RHA), inferior mesenteric artery (IMA)

#### **1. Introduction**

Laparoscopic cholecystectomy (LC) is commonly used nowadays to treat numerous conditions and diseases of the gallbladder and biliary tree. It is mandatory to specialists to get acquainted with all the technique, but additionally with anatomical variants of vascular supply in the extrahepatic biliary structures [1]. The cystic artery is often a solitary blood vessel that arises from the right branch from the proper hepatic artery (PHA). It constantly goes to the hepatobiliary triangle, which is encircled superiorly with the inferior surface of the liver, inferiorly with the cystic duct and, the common hepatic duct corresponds to medially [2]. According to Calot's triangle illustration, the superior border is made with the cystic artery [2]. While getting closer to the gallbladder, the cystic artery divides into two branches superficially and deeply running on the anterior and posterior

components of the gallbladder, correspondingly. Variants at the originations and course of CA are extremely typical. Uncontrolled arterial bleeding during LC is often a significant issue and might increase the likelihood of biliary duct injury. Consequently, appropriate recognition of the anatomy of the CA is essential. Cystic artery is excessively acknowledged to possess a highly diverse branching pattern. Therefore, given that LC had become the defacto standard to treat cholelithiasis, comprehension of anatomical vascular variations in hepatobiliary surgery has attained significance [3].
