Post-laparoscopic cholecystectomy extra-hepatic arterial pseudoaneurysm: An uncommon complication

Area of Science:

• Gastroenterology
• Vascular Surgery
• Interventional Radiology

Background:

• Laparoscopic cholecystectomy is a common procedure with a low complication rate.
• Vascular complications, though rare (0.8%), can occur due to thermal injury or clip application.
• Extra-hepatic artery pseudoaneurysms can lead to hemobilia, presenting with abdominal pain, GI bleeding, and jaundice weeks post-surgery.

Purpose of the Study:

• To present a case of post-cholecystectomy hemobilia caused by an extra-hepatic artery pseudoaneurysm.
• To illustrate the diagnostic and therapeutic approach to this rare complication.

Main Methods:

• A case of hemobilia presenting 3 weeks after laparoscopic cholecystectomy was investigated.
• Diagnosis involved clinical presentation, contrast-enhanced CT, and angiography.
• Treatment involved diagnostic and therapeutic angiography with embolization.

Main Results:

• The patient presented with melena and abdominal pain, consistent with hemobilia.
• An extra-hepatic artery pseudoaneurysm was diagnosed.
• Successful angioembolization was performed as treatment.

Conclusions:

• Extra-hepatic artery pseudoaneurysms are a potential cause of delayed hemobilia after laparoscopic cholecystectomy.
• Angiography is crucial for diagnosis and can be therapeutic via embolization.
• Angioembolization offers a successful treatment option for pseudoaneurysm-induced hemobilia.