Hepatic or Cystic Artery Pseudoaneurysms Following a Laparoscopic Cholecystectomy Literature review of aetiopathogenesis, presentation, diagnosis and management
Journal Title: Sultan Qaboos University Medical Journal - Year 2017, Vol 17, Issue 2
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. Te 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. Te overall mortality rate was 2.0%.
Authors and Affiliations
Norman O. Machado| Departments of Surgery, Sultan Qaboos University Hospital, Muscat, Oman, Adil Al-Zadjali| Departments of Surgery, Sultan Qaboos University Hospital, Muscat, Oman, Anupam K. Kakaria| Departments of Radiology & Molecular Imaging, Sultan Qaboos University Hospital, Muscat, Oman, Shahzad Younus| Departments of Surgery, Sultan Qaboos University Hospital, Muscat, Oman, Mohamed A. Rahim| Departments of Surgery, Sultan Qaboos University Hospital, Muscat, Oman, Rashid Al-Sukaiti| Departments of Radiology & Molecular Imaging, Sultan Qaboos University Hospital, Muscat, Oman
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- EP ID EP14765
- DOI 10.18295/squmj.2016.17.02.002
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