Cystohepatic triangle
Enable an agent to recognize the cystohepatic triangle, document its anatomical boundaries and observed contents, and identify uncertainty relevant to clinical interpretation.
Research draft, second pass
A second pass drafted this model: the structure a model of this thing needs, and what is known about it in the world. The line under this one says how the second half was obtained - researched against sources, or recalled without web access, in which case nothing here was read anywhere and every claim is a lead to verify. Unreviewed either way.
Researched by: Codex
Bundle → Layer → Finding → Questions Filled
5 bundles · 9 layers · 12 findings · 20 questions
Identity and boundary convention Establish which anatomical region an observation or source intends by cystohepatic triangle.
Anatomical region identity
Connect the registry concept to an explicitly bounded region.
Three-landmark definition
Use the cystic duct, common hepatic duct and inferior liver surface to define the working region. [SAGES](https://www.sages.org/safe-cholecystectomy-program/)
- Does the source explicitly define the region using these three landmarks? definition
- Which boundaries are directly observed and which are inferred? boundary
Terminology reconciliation
Preserve the meaning attached to each anatomical name.
Calot label interpretation
Record the boundary definition attached to 'Calot's triangle' before mapping it to this entry; published usage distinguishes historical and modern descriptions. [Calot's triangle](https://pubmed.ncbi.nlm.nih.gov/23519829/)
- What superior boundary does this source assign to Calot's triangle? definition
- Which source establishes the intended equivalence or distinction between the names? provenance
Boundaries and local relationships Record the observed landmarks and the structures related to the region.
Boundary identification
Document evidence for the ductal and hepatic landmarks individually.
Landmark continuity
Record how each proposed boundary is identified, including visible continuity and unresolved segments.
- What evidence identifies the proposed cystic duct rather than another duct? boundary
- What evidence identifies the common hepatic duct and the inferior liver surface in this observation? boundary
Regional structure mapping
Describe vessels, ducts and other observed tissues in relation to the boundaries.
Structure course and identity
Maintain separate records for an observed structure's course, proposed identity and evidence; location within the triangle alone does not establish identity.
- Which structures are observed within, crossing or immediately bordering the region? boundary
- What observed continuity or other evidence supports each proposed duct or vessel identity? provenance
Variation and observability Capture departures from the expected arrangement and limitations of the available view.
Anatomical departures
Record observed differences without assigning an unsupported explanation.
Variant or distorted arrangement
Describe unexpected boundary or structure relationships and distinguish suspected anatomical variation from suspected acquired or positional distortion.
- Which specific ductal, arterial or boundary relationship differs from the reference arrangement? boundary
- What evidence supports variation, disease-related distortion or positioning as the explanation? provenance
View-dependent evidence
Attach visibility judgments to the actual observation conditions.
Visibility and occlusion
Record viewpoint, timing and obscuring material or tissue so that incomplete visualization is not interpreted as anatomical absence.
- Which boundaries or crossing structures cannot be assessed in this view, and what obscures them? boundary
- Which image, frame or specimen observation supports the visibility judgment? provenance
Clinical identification and review Connect regional observations to clinical review without turning the model into an operative protocol.
Critical view evidence
Relate the triangle assessment to the additional observations required for the critical view of safety.
Independent critical view components
Record triangle clearance separately from exposure of the cystic plate through separation of the lower gallbladder and demonstration of two structures entering the gallbladder. [SAGES](https://www.sages.org/safe-cholecystectomy-program/)
- What evidence supports each critical view component independently? provenance
- Has the responsible clinician documented the overall assessment, or is only the triangle visible? action
Unresolved anatomy review
Make uncertain identification explicit and traceable to subsequent clinical review.
Identification discrepancy
Preserve competing interpretations of a boundary or traversing structure and record whether expert review resolved them.
- Which unresolved boundary or structure identity prevents a reliable anatomical interpretation? boundary
- What additional evidence or clinician review is needed to resolve the discrepancy? action
Evidence and external alignment What the world already says about this thing, gathered so the model can be checked against it.
Reported evidence
Findings from the breadth pass, kept separate from the structural claims.
Check these first
Recalled without web access and unsourced; every item is a lead to verify.
- Which of these check these first hold for the sense of Cystohepatic triangle this model covers, and on what evidence? provenance
Real-world use
Recalled without web access and unsourced; every item is a lead to verify.
- Which of these real-world use hold for the sense of Cystohepatic triangle this model covers, and on what evidence? provenance
Failure modes and hazards
Recalled without web access and unsourced; every item is a lead to verify.
- Which of these failure modes and hazards hold for the sense of Cystohepatic triangle this model covers, and on what evidence? provenance
Neighbouring kinds and how to tell them apart
Recalled without web access and unsourced; every item is a lead to verify.
- Which of these neighbouring kinds and how to tell them apart hold for the sense of Cystohepatic triangle this model covers, and on what evidence? provenance
Classifiers Filled
- Family
- Thing Registry
- Category
- Physical world and living systems
- Entry kind
- thing
- Plane
- PHY
- Domain
- PHY.OBJ
What it is Filled
The cystohepatic triangle, also called the hepatocystic triangle, is an anatomical region bounded by the cystic duct inferiorly, the common hepatic duct medially, and the inferior surface of the liver superiorly, used as a landmark in gallbladder surgery.
In scope
- The cystic duct, common hepatic duct and inferior liver surface as defining boundary landmarks
- Terminological distinctions between the hepatocystic triangle and historical descriptions of Calot's triangle
- Spatial relationships of observed ducts, vessels and other tissues within or bordering the region
- Anatomical variation and distortion affecting recognition of the triangle
- Evidence supporting identification and the triangle's contribution to assessment of the critical view of safety
Out of scope
- Complete anatomical models of the liver, gallbladder and extrahepatic biliary tree
- Independent models of the cystic artery and hepatic arterial system
- Diagnosis and management of gallbladder or bile duct diseases
- The complete cholecystectomy procedure and selection of operative techniques
- Autonomous authorization to divide, clip or otherwise manipulate anatomical structures
Why it exists Filled
Enable an agent to recognize the cystohepatic triangle, document its anatomical boundaries and observed contents, and identify uncertainty relevant to clinical interpretation.
Distinguishing features Filled
- Identify a region bounded by the cystic duct, common hepatic duct and inferior liver surface; adjacency to the gallbladder alone is insufficient. [SAGES](https://www.sages.org/safe-cholecystectomy-program/)
- Check the stated superior boundary when a source uses 'Calot's triangle': historical and modern definitions differ, so the label alone does not establish equivalence. [Calot's triangle](https://pubmed.ncbi.nlm.nih.gov/23519829/)
- Represent an anatomical region defined by relationships among structures, rather than a separate organ, duct or vessel.
- Distinguish identification of the triangle from achievement of the critical view of safety, which requires additional observations. [SAGES](https://www.sages.org/safe-cholecystectomy-program/)
What robots and AI may and may not do Filled
Must not
- Direct or perform surgical steps without the operating surgeon in control.
- Label a structure in a live operation with confidence it does not have.
- Share identifiable operative video without consent.
Only with a human decision
- Any decision to clip or divide a structure in the triangle.
May
- Describe the triangle and its role as a safety landmark in gallbladder surgery.
- Support surgical teams in documenting that structures were identified before division, when authorized.
Moral aspects Filled
- Misidentifying ducts here causes bile duct injuries that change patients' lives.
- Patients deserve an honest account when complications occur.
Who is affected
- Surgical patients
- Surgeons and theatre teams
Owners Filled
Steward
Nobody: part of a person's body; the surgical team answers for care during an operation.
Links to other meta-models Filled
parent
- Q66557532 - registry parent class
What else AI and robots need to interact with it Incomplete
Identity and identifiers required Filled
- Vercy registry: vr.tr.cystohepatic-triangle
- Wikidata: Q604046 (https://www.wikidata.org/wiki/Q604046)
Direct properties required Filled
- Boundary convention: Liver-bounded hepatocystic convention; historical Calot convention; other explicitly described convention; unspecified
- Boundary landmark identification: Links to the observed cystic duct, common hepatic duct and inferior liver surface, each with an identification status
- Boundary visibility: For each boundary: visible; partially visible; obscured; outside the observation; not assessed
- Observed structure relationship: Within; crossing; bordering; adjacent; relationship unresolved
- Regional distortion: Not observed; suspected; observed; indeterminate, with the supporting evidence and suspected cause recorded separately
- Observation context: Operative view; imaging study; anatomical specimen; illustration, with modality or viewpoint specified
- Critical view assessment: Not assessed; incomplete; documented as achieved by the responsible clinician; indeterminate
Recognition required Filled
- Bounded by the cystic duct, the common hepatic duct and the underside of the liver.
- Usually contains the cystic artery.
Capabilities and actions required Filled
- Annotate the triangle and its separately identified boundary landmarks in a clinical image or anatomical representation.
- Compare source terminology and flag incompatible boundary definitions.
- Map observed vessels and ducts relative to the triangle while retaining unresolved identities.
- Compare observations across viewpoints or time points to expose inconsistent anatomical interpretations.
- Assemble evidence for clinician review of anatomical identification and critical view criteria.
- Flag inadequate evidence and request expert review when boundaries or structures remain uncertain.
Hazards and failure modes required Filled
- Misidentification of ducts can cause bile duct injury.
- Inflammation and anatomical variation obscure the landmarks.
Standards and interfaces required Missing, in the backlog
Not described yet. This gap is in the card backlog.
Context of use required Missing, in the backlog
Not described yet. This gap is in the card backlog.
Sources Filled
- Wikidata item Q604046: Cystohepatic triangle - identity and sense of the item
- Wikipedia: Cystohepatic triangle - general description of the item
Open questions
- Does the registry intend the liver-bounded hepatocystic triangle specifically, and does an existing Vercy world model already own this concept?
- Which authoritative anatomical terminology source should govern equivalence among cystohepatic triangle, hepatocystic triangle and Calot's triangle?
- Which contents and anatomical variants should be represented as expected, optional or exceptional after review of primary anatomical studies?
- What evidence and review criteria should distinguish confirmed landmark identification from a plausible interpretation across imaging, operative views and specimens?
- How should the region be represented after surgery or major distortion when its original boundaries can no longer be identified?
Machine files
Provenance
thing registry research (pass 2) · unreviewed
Built from: models/things/publications/thing-q604046/spec.json