Hemobilia After Laparoscopic Cholecystectomy: Imaging Features and Management of an Unusual Complication

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Feng WenQi Yong Guo

Abstract

To assess the imaging features and the management of hemobilia after laparoscopic cholecystectomy (LC). A total of 12 patients who were treated for hemobilia after LC were included in the study. Selective arteriography was performed to find the bleeding artery. Coils or microcoils were deployed superselectively to occlude the bleeding branch. The clinical course, imaging findings, the embolic effect, complications, and follow-up were evaluated. Risk factors for hemobilia included a variant ductal anatomy, a variant cystic artery, and intraoperative adhesion. Abdominal computed tomography (CT) could provide the diagnostic signs as follows: a hematocele in the abdominal cavity, the gallbladder fossa, and the bile duct, biliary dilation, pseudoaneurysm of the right hepatic artery, and contrast extravasations on contrast-enhanced CT. No rebleeding occurred after the transcatheter arterial embolization in all patients without immediate procedural complications. Gallbladder triangle anatomic variation and intraoperative adhesion were the risk factors for hemobilia after LC. Abdominal CT is a useful examination for the diagnosis. Transcatheter arterial embolization is the therapeutic option of choice.

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Citations

Apr 2, 2019·Liver International : Official Journal of the International Association for the Study of the Liver·Alex ZhornitskiyJames H Tabibian
Jun 24, 2020·Journal of Gastrointestinal Cancer·Rani BerryJames H Tabibian
Aug 18, 2018·Gastroenterology Research and Practice·Rani BerryJames H Tabibian
Jun 24, 2017·Journal of Clinical Gastroenterology·Scott CathcartMicheal Schuster

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