Hepatic or Cystic Artery Pseudoaneurysms Following a Laparoscopic Cholecystectomy: Literature review of aetiopathogenesis, presentation, diagnosis and management

Sultan Qaboos University Medical Journal
Norman O MachadoRashid Al-Sukaiti

Abstract

Pseudoaneurysms (PSAs) of the hepatic and/or cystic artery are a rare complication following a laparoscopic cholecystectomy (LC). Generally, PSA cases present with haemobilia several weeks following the procedure. Transarterial embolisation (TAE) is considered the optimal management approach. We report a 70-year-old woman who presented to the Sultan Qaboos University Hospital, Muscat, Oman, in 2016 with massive hemoperitoneum two weeks after undergoing a LC procedure in another hospital. She was successfully managed using coil TAE. An extensive literature review revealed 101 cases of hepatic or cystic artery PSAs following a LC procedure. Haemobilia was the main presentation (85.1%) and the mean time of postoperative presentation was 36 days. The hepatic artery was involved in most cases (88.1%), followed by the cystic artery (7.9%) and a combination of both (4.0%). Most cases were managed with TAE (72.3%), with a 94.5% success rate. The overall mortality rate was 2.0%.

Citations

Aug 14, 2018·The British Journal of Radiology·Maciej PowerskiMaciej Pech
May 7, 2020·Surgical Case Reports·Takehiro AbikoSatoshi Hirano
Jun 22, 2019·Annals of Hepato-biliary-pancreatic Surgery·Vikas GuptaRakesh Kochhar
Feb 9, 2021·Journal of Community Hospital Internal Medicine Perspectives·Daniel JohSalim Surani
Nov 22, 2020·International Journal of Surgery Case Reports·Amber C TraaArjen L Diederik
Apr 24, 2021·International Journal of Surgery Case Reports·Sanjeev KharelPaleswan Joshi Lakhey
May 4, 2021·Curēus·Pratishtha SinghDylan C Morgan
May 18, 2021·Journal of Vascular Surgery Cases and Innovative Techniques·Isabella GrahamJimmy Haouilou

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