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Related Experiment Videos

Pseudoaneurysm following laparoscopic cholecystectomy.

Mansoor Ahmed Madanur1, Narendra Battula, Harsheet Sethi

  • 1Institute of Liver Studies, Kings College Hospital, Denmark Hill, London SE5 9RS, UK.

Hepatobiliary & Pancreatic Diseases International : HBPD INT
|June 6, 2007
PubMed
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Hepatic artery pseudoaneurysm (HAP) is a rare complication after laparoscopic cholecystectomy (LC) with bile leak. Prompt management is crucial, though late duct strictures can occur.

Area of Science:

  • Gastroenterology
  • Hepatobiliary Surgery
  • Vascular Surgery

Background:

  • Laparoscopic cholecystectomy (LC) is the standard gallbladder removal procedure.
  • Bile duct injuries and leaks can lead to serious complications like pseudoaneurysms.
  • Delayed healing of arterial injuries due to bile exposure can result in pseudoaneurysm formation.

Purpose of the Study:

  • To determine the incidence and outcomes of pseudoaneurysms in patients with bile leaks post-LC.
  • To analyze the presentation and management of these rare but serious complications.

Main Methods:

  • Retrospective analysis of a prospectively maintained liver database.
  • Inclusion criteria: patients with bile duct injury and bile leak following LC.
  • Data collection from January 2000 to December 2005.

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Main Results:

  • Four patients (4.5%) developed hepatic artery pseudoaneurysms (HAP) after LC with bile leak.
  • Presentations included haemobilia and massive intra-abdominal bleeding.
  • Coil embolization was effective in 3 patients; one required emergency laparotomy.
  • Two patients treated with embolization developed late common hepatic duct strictures.

Conclusions:

  • Hepatic artery pseudoaneurysm is a rare, potentially fatal complication of LC.
  • Biloma and infection are associated with pseudoaneurysm development.
  • Late duct strictures are a common sequela, potentially from unrecognized injury or embolization ischemia.