Anatomical classification of catterpillar hump of RHA and its surgical importance

Abstract

Ligation of cystic artery is important surgical step involving gallbladder and hepatobiliary surgery. Right hepatic artery may come very close to gallbladder & cystic duct and CHD in the form of “Caterpillar hump or Moynihan hump’’. Such hump has variations in position and depending on hump type, cystic artery anatomy is defined. In this situation right hepatic artery is liable to be mistakenly identified as cystic artery and it will be ligated prior to Cholecystectomy leading to right functional lobe of liver goes for necrosis. By defining types, increasing surgeon’s awareness, surgical complications will be reduced