Cystic vein

The cystic veins (TA: venae cysticae) are the main venous drainage of the gallbladder. They subsequently drain into the portal vein.

Gross anatomy

The cystic veins begin as venules running over the surface of the fundus and body of the gallbladder which merge proximate to the neck of the gallbladder, forming one or two main cystic veins. These are usually small (~1 mm calibre) veins which run alongside the cystic duct, and at right angles to the common bile duct.  The cystic vein(s) then drains into the portal vein, most commonly the right portal vein ^1,3,5,6.

Clinical importance

The position of the cystic veins serves as a key anatomical landmark of the structures of the triangle of Calot for the surgeons performing a laparoscopic cholecystectomy. 

History and etymology

For many years, surgical textbooks either did not mention the cystic vein at all or just stated that the venous drainage of the gallbladder was directly into the liver bed. This ignored the fact that the classic anatomical texts clearly stated that the cystic veins were well-known structures.

With the advent of laparoscopic cholecystectomy in the early 1990s, and the routine use of magnification of the gallbladder bed, it was obvious that the cystic veins were not only true vessels that had been there all alongbut were also fairly constant in their positioning. Nevertheless some well-known (and unnamed!) anatomical textbooks continue to contain incorrect information about venous drainage of the gallbladder ^1,3,5.