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

Norman O. Machado, Adil Al-Zadjali, Anupam K. Kakaria, Shahzad Younus, Mohamed A. Rahim, Rashid 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%.



Keywords


Hepatic Artery; Pseudoaneurysm; Hemoperitoneum; Therapeutic Embolization; Laparoscopic Cholecystectomy.

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DOI: http://dx.doi.org/10.18295/squmj.2016.17.02.002

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Sultan Qaboos University Medical Journal, College of Medicine and Health Sciences, Sultan Qaboos University, PO Box 35, Postal Code 123, Al-Khod, Muscat, Oman

ISSN (Print edition): 2075-051X ISSN (Internet edition): 2075-0528

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