Cystic Plexus, Lateral View

Description

Positioned in the right upper quadrant, the gallbladder (vesica biliaris) lies inferior to the liver and continues superiorly into the cystic duct, which joins the common hepatic duct to form the common bile duct. Along the neck of the gallbladder, the cystic artery courses medially and posteriorly toward the gallbladder wall, and a fine autonomic neural meshwork, the cystic plexus, wraps the artery and tracks with it to the fundus. Small ganglia and interconnecting nerve fibers are typically visible along this periarterial plexus, with branches extending toward the hepatic plexus proximally and toward the biliary tree distally. Relationships to Calot’s triangle (hepatocystic triangle) are implied: cystic duct inferiorly, common hepatic duct medially, and the inferior surface of the liver superiorly. A lateral perspective matters because it clarifies what surgeons encounter during cholecystectomy when the infundibulum is retracted laterally and inferiorly to open the hepatocystic triangle. Denervation or traction on the cystic plexus during dissection around the cystic artery contributes to postoperative dysautonomia of the biliary tract and can be a source of referred epigastric or right upper quadrant pain, especially when inflammation from acute cholecystitis obscures the normal tissue planes. This is where mistakes happen. Use this asset in hepatobiliary anatomy teaching, surgical anatomy modules on the critical view of safety, and publisher figures discussing autonomic innervation of the gallbladder, cystic duct, and extrahepatic bile ducts. It also supports clinical illustrations for operative reports or patient-facing explanations of nerve-related pain after laparoscopic cholecystectomy. Anatomical accuracy verified by SciePro's Medical Advisory Board.